Individual
MARYANN LITCHFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1810 MULKEY RD STE 200, AUSTELL, GA 30106-1150
(770) 315-8576
(770) 944-0829
Mailing address
49 HOSIERY MILL RD, STE 124, DALLAS, GA 30157-1688
(770) 443-6111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN087156NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN087156
RN LICENSE NUMBER
GA
Enumeration date
08/23/2011
Last updated
07/26/2021
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