Individual
ISRAEL TARIKU HABTAMU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2208
(404) 686-1000
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2208
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
196041
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196041
APRN
GA
01
—
A0514004
AMERICAN ACADEMY OF NURSE PRACTITIONER
—
Enumeration date
03/05/2015
Last updated
03/05/2015
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