Organization · Type 2 NPI

Mid Provider Inc

Gerontology Nurse Practitioner · Roswell, GA

NPI number 1962621532 Active

Practice location

1230 Worthington Hills Dr
Roswell, GA 30076-1753

Fax (770) 518-4026

Specialties and licenses

Taxonomy	Code	License
Gerontology Nurse Practitioner Primary	363LG0600X	RN133089 (GA)

Gerontology Nurse Practitioner: Definition to come...

About NPI 1962621532

Mid Provider Inc's National Provider Identifier is 1962621532, issued on Apr 24, 2007. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Roswell, GA. The record was last updated on Jan 5, 2010.