Individual
BONNIE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN NP-BC
Contact information
Practice address
1762 CLIFTON ROAD NE, ATLANTA, GA 30022
(404) 778-4818
Mailing address
2518 MIDWAY RD, DECATUR, GA 30030-4566
(404) 274-3273
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
166564
GA
Other
Enumeration date
12/06/2013
Last updated
12/06/2013
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