Individual
NISHA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4778 N HENRY BLVD STE 202, STOCKBRIDGE, GA 30281
(770) 474-8781
(770) 474-8670
Mailing address
4385 RIVERSIDE LN SW, LILBURN, GA 30047-4552
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN202547
GA
Other
Enumeration date
07/08/2017
Last updated
08/16/2018
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