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Individual

SOPHIA MARIE ARTIST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
7180 SOUTHLAKE PKWY, MORROW, GA 30260-4178
(770) 968-6994
Mailing address
3424 BAYLOR CIR, MCDONOUGH, GA 30253-6157
(313) 742-6780
(678) 519-0645

Taxonomy

Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
RN285743
GA
163WC1500X
Community Health Registered Nurse
RN285743
GA
163WC1600X
Continuing Education/Staff Development Registered Nurse
RN285743
GA
174200000X
Meals Provider
251S00000X
Community/Behavioral Health Agency
261QA0600X
Adult Day Care Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QR1300X
Rural Health Clinic/Center
385H00000X
Respite Care

Other

Enumeration date
04/21/2022
Last updated
06/16/2022
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