Individual
LARRICE TELA GORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 PEACHTREE ST NE STE 105, ATLANTA, GA 30309-3023
(470) 749-3520
Mailing address
174 EMERALD POINTE DR, CARROLLTON, GA 30116-9409
(470) 670-7280
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
RN222604
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN222604
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363LP0808X
—
GA
Enumeration date
02/23/2018
Last updated
02/19/2025
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