Individual
MISS TSEDAY SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-C
Contact information
Practice address
1700 TREE LN STE 190, SNELLVILLE, GA 30078-6766
(770) 736-6300
Mailing address
631 PROFESSIONAL DR, STE 360, LAWRENCEVILLE, GA 30046-3367
(770) 962-4895
(770) 962-4792
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN172768NP
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN172768
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
923160586A
—
GA
Enumeration date
11/20/2006
Last updated
05/09/2023
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