Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | RN217908 | GA |
NPI | 1003388828 |
---|---|
Provider Name | Ms. April Allen |
First Address | Columbus, GA 31909-6021 |
Second Address | Columbus, GA 31909-5981 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2018 |
Last Update Date | 24/11/2020 |