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Individual

ASIA DAY STANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
2281 HOLLY LYNN CT STE A, CANTON, GA 30115-8755
(478) 223-3977
Mailing address
1425 SHILOH WAY NW, KENNESAW, GA 30144-5242

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
308514
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
872279979
GA
Enumeration date
12/11/2021
Last updated
03/02/2022
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