Individual
KATARRA ASHLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 MEDICAL WAY STE E, RIVERDALE, GA 30274-2533
(470) 599-2324
Mailing address
949 CHURCH ST, DECATUR, GA 30030-1872
(470) 599-2324
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN073505
GA
Other
Enumeration date
08/06/2022
Last updated
08/06/2022
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