Individual
MRS. AUDREY LOGGINS LOVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1404 RIVER PL STE 303, BRASELTON, GA 30517-5600
(770) 848-9335
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN215314
GA
363LF0000X
Family Nurse Practitioner
Primary
RN215314
GA
Other
Enumeration date
03/14/2023
Last updated
06/16/2023
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