Individual
CLAYTON KENNETH ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP
Contact information
Practice address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-7001
Mailing address
216 LITTLE BROOK LN, WOODSTOCK, GA 30188-1938
(770) 866-8453
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN290383
GA
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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