Individual
MR. DAFE BENEDICT SIEBERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
5402 LAUREL RIDGE DR, ALPHARETTA, GA 30005-2606
(773) 653-7744
Mailing address
5402 LAUREL RIDGE DR, ALPHARETTA, GA 30005-2606
(773) 653-7744
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN235141
GA
163WD1100X
Peritoneal Dialysis Registered Nurse
RN235141
GA
163WH0500X
Hemodialysis Registered Nurse
Primary
RN235141
GA
163WI0500X
Infusion Therapy Registered Nurse
RN235141
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN235141
REGISTERED PROFESSIONAL NURSE
GA
Enumeration date
06/19/2018
Last updated
06/19/2018
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