Organization
HEALTHY STAGES PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NAIOMI M SHOCKLEY APRN (OWNER)
(770) 960-9999
Entity
Organization
Contact information
Practice address
1115 MOUNT ZION RD, SUITE E, MORROW, GA 30260-2266
(770) 960-9999
(770) 960-0931
Mailing address
1115 MOUNT ZION RD, SUITE E, MORROW, GA 30260-2266
(770) 960-9999
(770) 960-0931
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN159492
GA
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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