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Individual

LILLIAN MARIA NAGADDYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1203 CLEVELAND AVE, SUITE 2-D, EAST POINT, GA 30344-3417
(404) 684-7111
(404) 684-7112
Mailing address
1203 CLEVELAND AVE, SUITE 2-D, EAST POINT, GA 30344-3417
(404) 684-7111
(404) 684-7112

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN143664
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06081973
BIRTH DATE
01
RN143664
RN LICENSE
GA
Enumeration date
06/29/2007
Last updated
07/08/2007
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