Individual
MRS. STELLA W. MWANGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 JOHNSON FERRY RD STE 600, ATLANTA, GA 30342-1739
(404) 256-4777
(404) 256-5515
Mailing address
1100 JOHNSON FERRY RD STE 600, ATLANTA, GA 30342-1739
(404) 256-4777
(404) 256-5515
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN205334
GA
363LP2300X
Primary Care Nurse Practitioner
RN205334
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003233370A
—
GA
01
—
G19712A
MEDICARE PTAN
GA
Enumeration date
11/20/2019
Last updated
11/27/2020
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