Individual
MAUDELINE KOLU ST JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
(678) 212-6343
Mailing address
5332 PARAMOUNT VIEW WAY, SUGAR HILL, GA 30518-8618
(952) 239-4378
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
236135
GA
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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