Individual
JEAN SKINNER MICHALOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3602 MARATHON CIR, AUSTELL, GA 30106-6821
(770) 222-0253
(770) 222-9415
Mailing address
3490 BRIGHTON PL, MARIETTA, GA 30062-6243
(770) 354-0435
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R122312
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R122312
GA RN
GA
Enumeration date
04/26/2020
Last updated
04/26/2020
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