Individual
CARA MICHELLE CLOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
320 PARKWAY DR NE, ATLANTA, GA 30312-1213
(404) 522-6569
(404) 522-8265
Mailing address
320 PARKWAY DR NE, ATLANTA, GA 30312-1213
(404) 522-6569
(404) 522-8265
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003886
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002426A
—
GA
01
—
202I978663
MEDICARE
GA
01
—
775100
BCBS
—
01
—
P00159412
MEDICARE RAILROAD
GA
Enumeration date
08/30/2006
Last updated
03/19/2018
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