Individual
GERALDINE ECCLESTON MENCHION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP, BC
Contact information
Practice address
175 COUNTRY CLUB DR BLDG 100D, STOCKBRIDGE, GA 30281-7380
(678) 819-5497
(678) 601-1508
Mailing address
175 COUNTRY CLUB DR BLDG 100D, STOCKBRIDGE, GA 30281-7380
(404) 514-6066
(678) 601-1508
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN151173
GA
Other
Enumeration date
05/27/2022
Last updated
01/23/2023
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