| Nurse Practioner | |
|
4044 George Busbee Pkwy Nw Apt 4207 Kennesaw GA 30144-6890 | |
| (404) 579-1658 | |
| Not Available |
| Full Name | Nurse Practioner |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 4044 George Busbee Pkwy Nw Apt 4207, Kennesaw, Georgia |
| Authorized Official Name and Position | Rose Kombe (FNP) |
| Authorized Official Contact | 4045791658 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nurse Practioner Po Box 1234 Powder Springs GA 30127-7234 Ph: (404) 579-1658 | Nurse Practioner 4044 George Busbee Pkwy Nw Apt 4207 Kennesaw GA 30144-6890 Ph: (404) 579-1658 |
| NPI Number | 1629519202 |
|---|---|
| Provider Enumeration Date | 03/15/2017 |
| Last Update Date | 03/15/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629519202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 193760 (Georgia) | Primary |
| 305S00000X | Point Of Service | 193760 (Georgia) | Secondary |
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