Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | R073873 | GA |
NPI | 1376614974 |
---|---|
Provider Name | Susan H Price |
First Address | Atlanta, GA 30308-2247 |
Second Address | Atlanta, GA 30308-2247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |