Individual
GEREMY LANCE WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, PMHNP-BC
Contact information
Practice address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(770) 644-1570
(770) 644-1576
Mailing address
128 VIVIAN LN, PEACHTREE CITY, GA 30269-2305
(646) 467-1015
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN205927
GA
Other
Enumeration date
02/01/2024
Last updated
03/20/2024
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