Individual
MISS STAISHA RENEE WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4406 TIMBERCREEK CIR, ROSWELL, GA 30076-8821
(678) 580-7654
Mailing address
4406 TIMBERCREEK CIR, ROSWELL, GA 30076-8821
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
239359
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1016
—
GA
Enumeration date
04/30/2021
Last updated
04/30/2021
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