Individual
STACEY COLEBROOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1919 JOHN WESLEY AVE, COLLEGE PARK, GA 30337-3605
(404) 762-9190
(404) 762-9101
Mailing address
3578 S FULTON AVE, HAPEVILLE, GA 30354-1756
(404) 768-1156
(404) 768-1146
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN157462
GA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN157462
GA
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
RN157462
GA
Other
Enumeration date
12/04/2007
Last updated
12/04/2007
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