Individual
EUNICE THEODOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8820 HOSPITAL DR, DOUGLASVILLE, GA 30134-2266
(770) 947-3000
(770) 947-3012
Mailing address
8820 HOSPITAL DR, DOUGLASVILLE, GA 30134-2266
(770) 947-3000
(770) 947-3012
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN244960
GA
363LP2300X
Primary Care Nurse Practitioner
0024172755
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720471147
—
VA
Enumeration date
03/10/2015
Last updated
09/26/2024
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