Individual
JIJI VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
69 GOLD MAPLE RD, LAWRENCEVILLE, GA 30043-6530
(678) 267-4164
Mailing address
69 GOLD MAPLE RD, LAWRENCEVILLE, GA 30043-6530
(678) 267-4164
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
214678
GA
Other
Enumeration date
09/13/2013
Last updated
09/13/2013
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