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Individual

VERONICA IKONGE GICHANA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1700 MEDICAL WAY, SNELLVILLE, GA 30078-2195
(478) 464-8134
Mailing address
280 NAVARRE DR, FAYETTEVILLE, GA 30214-4176
(678) 709-3728

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
RN225597
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN225597
GA

Other

Enumeration date
04/15/2022
Last updated
05/11/2023
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