Individual
MOJISOLA MARY BAKARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
11815 NORTHFALL LN STE 1001, ALPHARETTA, GA 30009-7973
(770) 377-5827
Taxonomy
Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
RN216951
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN216951
GA
Other
Enumeration date
11/03/2020
Last updated
12/09/2020
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