Individual
MRS. ALYSSA DANIELLE GUNAWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3369 BUFORD HWY NE, SUITE NUMBER 810, BROOKHAVEN, GA 30329-3722
(404) 321-4692
Mailing address
3413 ALEXANDER CIR NE, ATLANTA, GA 30326-1268
(480) 694-1260
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN264580
GA
Other
Enumeration date
02/21/2017
Last updated
02/21/2017
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