Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN209239 | GA |
NPI | 1093068397 |
---|---|
Provider Name | Mrs. Lauren Eichel Nourparvar |
First Address | Atlanta, GA 30319-6602 |
Second Address | Atlanta, GA 30319-6602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2012 |
Last Update Date | 24/10/2012 |