Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN202050 | GA |
NPI | 1033442454 |
---|---|
Provider Name | Kamara Suzanne Heard |
First Address | Marietta, GA 30060-1155 |
Second Address | Marietta, GA 30060-1155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2009 |
Last Update Date | 03/09/2010 |