Individual
NIAMBI VANTRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5418 LEE CIR, FOREST PARK, GA 30297-2731
(404) 216-5223
Mailing address
5418 LEE CIR, FOREST PARK, GA 30297-2731
(404) 216-5223
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW002933
GA
363L00000X
Nurse Practitioner
Primary
RN184231
GA
364S00000X
Clinical Nurse Specialist
RN184231
GA
Other
Enumeration date
05/07/2016
Last updated
05/07/2016
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