Individual
MISS CHARMAINE SIMONE ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, BC
Contact information
Practice address
35 JESSE HILL JR DR SE, ATLANTA, GA 30303-3032
(404) 785-9800
Mailing address
3111 BONITA SPRINGS CT, DOUGLASVILLE, GA 30135-9251
(404) 785-9800
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
183722
GA
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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