Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0105X | Surgery of the Hand | 1831396225 | GA |
NPI | 1831396225 |
---|---|
Provider Name | Dr. Brandy Noelle Cross |
First Address | Marietta, GA 30062-6215 |
Second Address | Marietta, GA 30062-6227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 31/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1831396225 | (05) | NC |
NC2087 | (05) | SC |