Individual
ELIZABETH LEIGH GASTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1356 CLIFTON RD NE, ATLANTA, GA 30322-1606
(404) 778-4500
Mailing address
2960 MONTVIEW DR SW, MARIETTA, GA 30060-5137
(256) 503-9930
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN240352
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN240352
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
03/31/2021
Last updated
10/21/2022
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