Individual
MRS. ILLONA M OUTLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE RN
Contact information
Practice address
265 BOULEVARD NE, THE CENTER FOR HEALTH AND REHABILITATION ROOM 402, ATLANTA, GA 30312
(404) 730-1629
(404) 730-1629
Mailing address
99 JESSE HILL JR DRIVE SE, ROOM 402 ALDREDGE HEALTH CENTER, ATLANTA, GA 30303
(404) 730-1655
(404) 730-1629
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN045618
GA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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