Individual
NATHALIE DE GUSMAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1607 BARRINGTON VW, STONE MOUNTAIN, GA 30087-1846
(678) 582-9317
Mailing address
1607 BARRINGTON VW, STONE MOUNTAIN, GA 30087-1846
(678) 582-9317
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396414677
CIGNA
GA
Enumeration date
07/22/2022
Last updated
07/22/2022
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