Individual
EMMANUELA ONYINYECHI IREBUISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 812-2369
(706) 845-3194
Mailing address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 812-2369
(706) 845-3194
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN246020
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN246020
GA
Other
Enumeration date
07/18/2018
Last updated
02/20/2023
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