Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | R068769 | GA |
NPI | 1225105612 |
---|---|
Provider Name | Aimee L Poor |
First Address | Atlanta, GA 30308-2247 |
Second Address | Atlanta, GA 30308-2247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |