Individual
ROYDALE JERMAINE WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1064
(404) 712-2000
Mailing address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1064
(404) 712-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN276174
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN276174
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN276174
GEORGIA BOARD OF NURSING RN AND NP LICENSES
GA
Enumeration date
08/25/2017
Last updated
08/30/2021
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