Individual
MRS. MICHELLE DANEE' ATHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-2266
Mailing address
85 SWEET BRIAR TRL, FAYETTEVILLE, GA 30215-5900
(770) 596-9881
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN166369
GA
163WC0200X
Critical Care Medicine Registered Nurse
RN166369
GA
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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