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Individual

REBECCA COLLINS MORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
775 POPLAR RD STE 310, NEWNAN, GA 30265-8303
(770) 251-2590
(770) 251-1410
Mailing address
1800 HOWELL MILL RD NW STE 800, ATLANTA, GA 30318-0922
(678) 298-3239
(404) 477-1162

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11156
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11156
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
10/29/2021
Last updated
05/16/2023
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