Individual
STEPHANIE HACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, MPH
Contact information
Practice address
524 SEMINOLE AVE NE, ATLANTA, GA 30307-1418
(203) 214-5551
Mailing address
524 SEMINOLE AVE NE, ATLANTA, GA 30307-1418
(203) 214-5551
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6782
GA
Other
Enumeration date
05/22/2013
Last updated
05/22/2013
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