Individual
MARY OMOROGBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 GWINNETT DR, LAWRENCEVILLE, GA 30046-5671
(678) 507-7212
Mailing address
311 GWINNETT DR, LAWRENCEVILLE, GA 30046-5671
(678) 507-7212
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN266971
GA
Other
Enumeration date
09/15/2022
Last updated
02/27/2023
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