Individual
KIDIST SEYOUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
445 WINN WAY, DECATUR, GA 30030-1707
(404) 294-3821
(404) 508-7844
Mailing address
445 WINN WAY, PO BOX 987, DECATUR, GA 30030-1707
(404) 294-3821
(404) 508-7844
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
175484
GA
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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