Individual
MS. NICKY ANTWA STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE TECH
Contact information
Practice address
1066 FOREST VALLEY DR SE, ATLANTA, GA 30354-3610
(404) 363-1407
Mailing address
1066 FOREST VALLEY DR. SE, ATLANTA, GA 30354-3610
(404) 363-1407
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0000028031
GA
Other
Enumeration date
11/20/2009
Last updated
11/20/2009
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