Individual
NISSY S CLEETUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 PARKLAKE DR NE STE 228, ATLANTA, GA 30345-3070
(404) 935-5900
(678) 252-2172
Mailing address
382 YELLOW SHOALS CT, LAWRENCEVILLE, GA 30044-5136
(770) 597-4808
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN188479
GA
Other
Enumeration date
01/06/2026
Last updated
01/06/2026
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