Individual
MARY NATSAI MATSHOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2484 WYNSLEY WAY, TUCKER, GA 30084-3767
(248) 894-6784
Mailing address
2484 WYNSLEY WAY, TUCKER, GA 30084-3767
(248) 894-6784
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG04210053
GA
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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