Individual
WANDA MCGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1514 VERNON RD, LAGRANGE, GA 30240-4131
(706) 882-1411
Mailing address
5665 NEW NORTHSIDE DR, ATLANTA, GA 30384-0001
(770) 874-5400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN066539
GA
Other
Enumeration date
09/14/2006
Last updated
05/07/2020
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