Individual
EMMIE NORVILLE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
1120 15TH ST # 6033, AUGUSTA, GA 30912-0004
(706) 721-2331
(706) 721-7531
Mailing address
1499 WALTON WAY STE 1400, AUGUSTA, GA 30901-2603
(706) 446-5941
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
RN227108
GA
Other
Enumeration date
10/27/2017
Last updated
11/29/2017
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