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Individual

MS. THERESA COMRIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
5656 BAHIA MAR CIR, STONE MOUNTAIN, GA 30087-1603
(770) 823-2403
Mailing address
5656 BAHIA MAR CIR, STONE MOUNTAIN, GA 30087-1603
(770) 823-2403

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN091927
GA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN091927
GA
163WG0600X
Gerontology Registered Nurse
RN091927
GA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN091927
GA

Other

Enumeration date
06/30/2012
Last updated
06/30/2012
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