Individual
KHELIN VIRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC/FNP-C
Contact information
Practice address
250 E PONCE DE LEON AVE, DECATUR, GA 30030-3440
(404) 727-7980
Mailing address
530 PIEDMONT AVE NE APT 608, ATLANTA, GA 30308-4409
(207) 415-5955
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN324425
GA
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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