Individual
TAKEYA RENEE FOGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
14 CHEROKEE RD, CEDARTOWN, GA 30125-4381
(770) 749-9600
(770) 749-9628
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(706) 295-5331
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN193378
GA
Other
Enumeration date
12/05/2017
Last updated
04/01/2024
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