Individual
BREANNE MASSUNG BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP-BC
Contact information
Practice address
550 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046
(378) 312-3970
Mailing address
550 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7688
(678) 312-3970
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
RN203901
GA
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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