Organization
CORNERSTONE PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CANTRELL CPNP (OWNER)
(404) 394-8001
Entity
Organization
Contact information
Practice address
2700 BRASELTON HWY STE 1, DACULA, GA 30019-3207
(678) 543-9400
Mailing address
2700 BRASELTON HWY STE 1, DACULA, GA 30019-3207
(678) 543-9400
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
043986
GA
208000000X
Pediatrics Physician
RN166999
GA
208000000X
Pediatrics Physician
RN170835
GA
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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