Individual
MRS. LAQUETA NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3970 DEPUTY BILL CANTRELL MEMORIAL RD, CUMMING, GA 30040
(678) 513-2273
Mailing address
2400 HERODIAN WAY SE STE 220, SMYRNA, GA 30080-8500
(770) 383-1415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RN145567
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN145567
FNP LICENSE
GA
Enumeration date
10/28/2019
Last updated
11/29/2022
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