Individual
MS. DIANE L WIRTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
1525 CLIFTON RD NE, SUITE 207, ATLANTA, GA 30322-4200
(404) 778-4451
(404) 778-4355
Mailing address
1306 JANMAR RD, SNELLVILLE, GA 30078-2103
(770) 979-1154
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN108564 NP
GA
Other
Enumeration date
08/17/2006
Last updated
07/18/2007
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