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Individual

MRS. MA VICTORIA AQUINO KHERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
AGPCNP-BC

Contact information

Practice address
2467 GOLDEN CAMP RD, AUGUSTA, GA 30906-5515
(706) 790-4440
Mailing address
608 BURGAMY PASS, GROVETOWN, GA 30813-5855
(714) 624-5631

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
243278
GA
363LG0600X
Gerontology Nurse Practitioner
243278
GA
363LP2300X
Primary Care Nurse Practitioner
243278
GA

Other

Enumeration date
12/28/2016
Last updated
12/28/2016
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