Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN234125 | GA |
NPI | 1063053478 |
---|---|
Provider Name | Emily Elizabeth Adams |
First Address | Marietta, GA 30066-6244 |
Second Address | Atlanta, GA 30318-5252 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2019 |
Last Update Date | 07/10/2019 |