Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN183847 | GA |
NPI | 1033570353 |
---|---|
Provider Name | Mrs. April D Joseph |
First Address | Jonesboro, GA 30236-1106 |
Second Address | Jonesboro, GA 30236-1106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2016 |
Last Update Date | 17/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
463041216 | (05) | GA |