Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | RN116775 | GA |
NPI | 1043465941 |
---|---|
Provider Name | Mrs. Jennifer A Button |
First Address | Atlanta, GA 30308-2247 |
Second Address | Atlanta, GA 30322-1014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2008 |
Last Update Date | 20/11/2008 |