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Individual

ANGEL BROWN BOULWARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
2200 MEDICAL CENTER BLVD STE 400, LAWRENCEVILLE, GA 30046-7769
(678) 582-8586
Mailing address
3610 WYNTERSET DR, SNELLVILLE, GA 30039-8631
(404) 388-3421

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN172317
GA
363LF0000X
Family Nurse Practitioner
Primary
RN172317
GA

Other

Enumeration date
10/15/2012
Last updated
10/10/2025
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