Individual
CHENNEL KEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-1000
Mailing address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
Primary
RN181513
GA
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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