Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | RN094340 | GA |
NPI | 1013241736 |
---|---|
Provider Name | Lori A Dalcour |
First Address | Atlanta, GA 30312-1273 |
Second Address | Atlanta, GA 30312-1273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2009 |
Last Update Date | 28/09/2009 |