Individual
XIOBAHN SAMORA HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
948 ASHTON PARK CT, LAWRENCEVILLE, GA 30045-7083
(404) 734-2919
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN296278
GA
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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