Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | RN195478 | GA |
NPI | 1255870770 |
---|---|
Provider Name | Renee Allen-Murray |
First Address | Lithonia, GA 30058-6220 |
Second Address | Lithonia, GA 30058-6220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2017 |
Last Update Date | 16/02/2017 |