Individual
VERA MAHOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1115 MOUNT ZION RD, STE J, MORROW, GA 30260-2266
(404) 422-0027
Mailing address
1001 REDDY FARM RD, GRAYSON, GA 30017-1754
(404) 883-9140
(531) 200-7387
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN220109
GA
363LA2200X
Adult Health Nurse Practitioner
RN220109
GA
Other
Enumeration date
11/13/2017
Last updated
01/07/2021
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