Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN206295 | GA |
NPI | 1023664232 |
---|---|
Provider Name | Messeret Yohannes |
First Address | Atlanta, GA 30308-2012 |
Second Address | Atlanta, GA 30308-2012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2019 |
Last Update Date | 13/08/2019 |