Organization
PROFESSIONAL NURSING SERVICES
Active
Other names
n/a
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANIECE EYVETTE PRINCE RN (PARTNER/NURSE)
(678) 368-8655
Entity
Organization
Contact information
Practice address
7136 WOODSTONE DR, LITHONIA, GA 30058-9000
(678) 368-8655
Mailing address
7136 WOODSTONE DR, LITHONIA, GA 30058-9000
(678) 368-8655
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
00228363
GA
Other
Enumeration date
12/27/2011
Last updated
12/27/2011
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