Individual
MRS. GINA P CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C-FNP
Contact information
Practice address
330 TURNER MCCALL BLVD SW STE 107, ROME, GA 30165-5631
(706) 509-6439
(770) 607-1339
Mailing address
20 COLLINS DR, SUITE B, CARTERSVILLE, GA 30120-2486
(770) 607-0795
(770) 607-1339
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN120899
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000836382B
—
GA
Enumeration date
09/20/2006
Last updated
08/10/2021
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