Individual
OMOSEDE JEMIMAH NOSA-OVIASU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1397 MANCHESTER DR NE, CONYERS, GA 30012
(339) 440-1595
Mailing address
985 SPANISH MOSS TRL, LOGANVILLE, GA 30052-6733
(339) 440-1595
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN241611
GA
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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