Individual provider · Type 1 NPI
Grace Tamu Fomunung, NURSE PRACTITIONER
Psychiatric/Mental Health Nurse Practitioner · Dacula, GA
NPI number
1679028575
Active
Practice location
3206 Thimbleberry Trl
Dacula, GA 30019-7299
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | RN201867 (GA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | RN201867 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1679028575
Grace Tamu Fomunung, NURSE PRACTITIONER's National Provider Identifier is 1679028575, issued on Aug 20, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Dacula, GA. The record was last updated on Nov 7, 2019.