Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | RN046697 NP | GA |
NPI | 1013961937 |
---|---|
Provider Name | Ms. Clarice J. Schuyler |
First Address | Roswell, GA 30075-3920 |
Second Address | Marietta, GA 30067-8665 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 08/07/2007 |