Individual
IDA CURTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 COBB PKWY NW, ACWORTH, GA 30101-4178
(770) 974-3911
Mailing address
3540 COBB PKWY NW, ACWORTH, GA 30101-4178
(770) 974-3911
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN240337
GA
363LF0000X
Family Nurse Practitioner
RN240337
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN240337
RN NUMBER
GA
Enumeration date
02/22/2017
Last updated
02/22/2017
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