Individual
KOLISHA DEE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 LOWER FAYETTEVILLE RD STE B, NEWNAN, GA 30265-1133
(678) 631-4610
(678) 631-4611
Mailing address
1355 PEACHTREE ST NE STE 1600, ATLANTA, GA 30309-3276
(678) 223-7774
(678) 223-7799
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN213104
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175704A
—
GA
05
—
003175704D
—
GA
Enumeration date
02/23/2016
Last updated
01/07/2022
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