Individual
MRS. NGOZI DOREEN NWAISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
780 MCCONNELL RUN XING, GRAYSON, GA 30017-7804
(678) 467-6010
Mailing address
780 MCCONNELL RUN XING, GRAYSON, GA 30017-7804
(678) 467-6010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN188872
GA
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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