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NPI Code Detail

MEDICARE: MRS. CHARMECIA GONZALEZ AGNPC

MEDICARE:  MRS. CHARMECIA  GONZALEZ  AGNPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramGA

General Provider Information

NPI Number : 1497453583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHARMECIA GONZALEZ AGNPC
Provider Business Mailing Address
First Line : 8640 ROSWELL RD
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30350-1821
Country : US
Telephone Number : 770-696-2697
Fax Number :
Provider Business Practice Location Address
First Line : 8640 ROSWELL RD
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30350-1821
Country : US
Telephone Number : 770-696-2697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2023
Last Update Date : 02/20/2023

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Directions to “ MRS. CHARMECIA GONZALEZ AGNPC” Practice Location

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