Individual
AMY HERZOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, MPH, PMHNP-BC
Contact information
Practice address
4384 HIGHWAY 382 W, ELLIJAY, GA 30540-6978
(706) 255-9565
(706) 995-6861
Mailing address
4384 HIGHWAY 382 W, ELLIJAY, GA 30540-6978
(706) 255-9565
(706) 995-6861
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN292472
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN292472
GA
Other
Enumeration date
10/25/2022
Last updated
01/17/2025
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