Individual
MRS. MARIA S. GADDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1000 COWLES CLINC WAY STE M-200, GREENSBORO, GA 30642-4541
(706) 454-0159
(706) 454-0101
Mailing address
1835 SAVOY DR STE 300, ATLANTA, GA 30341-1071
(706) 454-0159
(706) 454-0101
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN076804
GA
363LF0000X
Family Nurse Practitioner
RN076804
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003168013E
—
GA
05
—
003168013F
—
GA
01
—
2025I00529
MEDICARE PTAN
GA
Enumeration date
09/24/2015
Last updated
08/20/2020
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