Individual
WILDWINE BELIZAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6919 PEACHTREE DUNWOODY RD APT 346, SANDY SPRINGS, GA 30328-1732
(347) 988-6474
Mailing address
6919 PEACHTREE DUNWOODY RD APT 346, SANDY SPRINGS, GA 30328-1732
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN315873
GA
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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