Individual
AURELIA LINDA BRYANT-MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2012 EASTVIEW PKWY STE 400, CONYERS, GA 30013-5701
(770) 679-0586
Mailing address
10720 WELLINGTON DR, COVINGTON, GA 30014-8709
(404) 992-7200
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
RN222976
GA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN222976
GA
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
RN222976
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN222976
BOARD OF NURSING
GA
Enumeration date
07/11/2018
Last updated
07/11/2018
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