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Individual

MALLORY WASHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
101 YORKTOWN DR STE 102, FAYETTEVILLE, GA 30214-1578
(770) 460-4285
Mailing address
4000 SHAKERAG HILL STE 201, PEACHTREE CITY, GA 30269-4047
(770) 486-7111
(770) 486-7131

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
232916
GA

Other

Enumeration date
06/17/2019
Last updated
06/17/2019
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