Individual
MRS. BLESSING ADA IKONNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP- C
Contact information
Practice address
2994 ATLANTA RD SE, SMYRNA, GA 30080-3655
(866) 389-2727
Mailing address
634 EXCALIBUR CT SE, MABLETON, GA 30126-4699
(574) 386-4030
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN197583
GA
Other
Enumeration date
07/20/2014
Last updated
11/10/2014
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