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ANTISIA LAVETTE THOMPSON-PEARSALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1412 MILSTEAD AVE NE STE 100, CONYERS, GA 30012-3877
(770) 483-9330
(501) 664-0889
Mailing address
1412 MILSTEAD AVE NE STE 100, CONYERS, GA 30012-3877

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
A005603
AR
363LA2100X
Acute Care Nurse Practitioner
Primary
RN299456
GA

Other

Enumeration date
05/07/2018
Last updated
09/23/2021
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