Individual
MRS. EMILEA EMADE MFORTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
868 YORK AVE SW, ATLANTA, GA 30310
(404) 752-1400
Mailing address
1032 GROVE TRAIL PASS, DOUGLASVILLE, GA 30134-8007
(404) 610-3591
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN191561
GA
Other
Enumeration date
06/17/2016
Last updated
06/14/2018
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