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Individual

MRS. ANGELIQUE LAURELYN PICKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
14 CHEROKEE RD, CEDARTOWN, GA 30125-4381
(770) 749-9600
(770) 749-9628
Mailing address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN186812
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003112877A
GA
Enumeration date
04/01/2011
Last updated
09/16/2013
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