Individual
MRS. FUNLOLA M GADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1365 ROCK QUARRY RD, SUITE 301, STOCKBRIDGE, GA 30281-5029
(770) 771-6580
Mailing address
1365 ROCK QUARRY RD, SUITE 301, STOCKBRIDGE, GA 30281-5029
(770) 771-6580
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN186624
GA
Other
Enumeration date
09/07/2011
Last updated
09/07/2011
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