Organization · Type 2 NPI
Lifegate Health & Wellness
Primary Care Nurse Practitioner · Kennesaw, GA
NPI number
1508481862
Active
Practice location
3784 Harris Blvd NW
Kennesaw, GA 30144-6098
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Home Health Agency | 251E00000X | None listed |
| Health Service Clinic/Center | 261QH0100X | None listed |
| Health Maintenance Organization | 302R00000X | None listed |
| Primary Care Nurse Practitioner Primary | 363LP2300X | None listed |
Primary Care Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1508481862
Lifegate Health & Wellness's National Provider Identifier is 1508481862, issued on Jun 12, 2020. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Kennesaw, GA. The record was last updated on Jun 12, 2020.