Taidesha Chanel Myrick, NP
Nurse Practitioner, Adult Health in Conyers, GA. Individual provider (NPI-1).
NPI number1710711684
StatusActive
Last updated in NPPESAug 31, 2024
Details
- NPI
- 1710711684
- Entity type
- Individual (NPI-1)
- Name
- Taidesha Chanel Myrick
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 31, 2024
- Certification date
- Aug 31, 2024
- Last updated
- Aug 31, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LA2200X | Nurse Practitioner, Adult Health | RN298582 | GA | Yes |
Practice location
2035 Flat Shoals Rd SeConyers, GA 30013-1809
Phone 770-922-1778
Mailing address
Po Box 3413Decatur, GA 30031-3413
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All 9 Adult Health Nurse Practitioner providers in Conyers · All 2,198 providers in Conyers
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