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Individual

DONYA J. BARTLETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN BC

Contact information

Practice address
150 CLINIC AVE, SUITE 202, CARROLLTON, GA 30117-4401
(770) 834-6988
(770) 834-1090
Mailing address
150 CLINIC AVE, SUITE 202, CARROLLTON, GA 30117-4401
(770) 834-6988
(770) 834-1090

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN130291 NP
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000952443A
GA
01
REF000128984
MEDICAID REFERENCE NUMBER
GA
Enumeration date
04/03/2006
Last updated
11/14/2007
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