Individual
SAMURAT I ONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
500 LANIER AVE W STE 908E, FAYETTEVILLE, GA 30214-7641
(321) 594-3390
Mailing address
500 LANIER AVE W STE 908E, FAYETTEVILLE, GA 30214-7641
(321) 594-3390
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
05250096
GA
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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