Individual
AIDA YESUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
631 PROFESSIONAL DR STE 350, LAWRENCEVILLE, GA 30046-3370
(770) 995-0630
Mailing address
1610 BROOK IVY DR, LAWRENCEVILLE, GA 30044-8849
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN239348
GA
363LF0000X
Family Nurse Practitioner
Primary
NCO-000001
GA
Other
Enumeration date
01/26/2021
Last updated
06/18/2021
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