Individual
MRS. MARY-THERESIA KEMNI WALLANG-NWAHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1260 ROSE TERRACE CIR, LOGANVILLE, GA 30052-9047
(610) 333-2809
Mailing address
1260 ROSE TERRACE CIR, LOGANVILLE, GA 30052-9047
(610) 333-2809
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
RN219548
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN219548
GA
Other
Enumeration date
12/06/2007
Last updated
11/25/2019
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