Individual
MS. LAURA MARTHA AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
221 THE ESPLANADE WAY SE, LOGANVILLE, GA 30052
(678) 457-0610
Mailing address
221 THE ESPLANADE WAY SE, LOGANVILLE, GA 30052-2190
(678) 457-0610
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN182243
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
RN182243
GA
Other
Enumeration date
04/23/2018
Last updated
06/22/2018
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