Individual
ALLISON BOARDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1975 LASALLE WAY, MARIETTA, GA 30062-8168
(404) 514-0058
Mailing address
1975 LASALLE WAY, MARIETTA, GA 30062-8168
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN275954
GA
Other
Enumeration date
06/08/2023
Last updated
06/08/2023
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