Individual
KIMBERLY BROOKE MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
140 EAGLE SPRING CT, STOCKBRIDGE, GA 30281-6441
(770) 302-0878
Mailing address
140 EAGLE SPRING CT, STOCKBRIDGE, GA 30281-6441
(770) 302-0878
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN197036
GA
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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