Individual
MISS REBECCA O' GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
95 COLLIER RD NW STE 3000, ATLANTA, GA 30309-1721
(404) 605-5422
Mailing address
PO BOX 116116, ATLANTA, GA 30368-6116
(605) 990-8975
(605) 592-0143
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN249182
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN249182
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003233125B
—
GA
Enumeration date
02/12/2020
Last updated
07/08/2020
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