Gwinnett Care At Home LLC
Nurse Practitioner, Family in Snellville, GA. Organization (NPI-2).
NPI number1336764802
StatusActive
Last updated in NPPESJun 10, 2020
Details
- NPI
- 1336764802
- Entity type
- Organization (NPI-2)
- Legal business name
- Gwinnett Care At Home LLC
- Organization subpart
- No
- Enumeration date
- Jun 10, 2020
- Certification date
- Jun 10, 2020
- Last updated
- Jun 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
3585 Edenderry DrSnellville, GA 30039-5961
Phone 617-480-9507
Mailing address
3585 Edenderry DrSnellville, GA 30039-5961
Phone 617-480-9507
Authorized official
Julienne Thomas
Nurse Practitioner
6174809507
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