Individual
ALEXANDRIA PORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1595 GA-34 E, NEWNAN, GA 30265
(470) 489-0090
Mailing address
1595 HIGHWAY 34 E, NEWNAN, GA 30265-2353
(470) 489-0090
(470) 589-2605
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP286755
GA
Other
Enumeration date
12/10/2025
Last updated
03/30/2026
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