Healthcare Provider Details
I. General information
NPI: 1467967109
Provider Name (Legal Business Name): MEDSOLUTION ZLN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/04/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3576 SHALLOWFORD RD NE STE A
CHAMBLEE GA
30341-2998
US
IV. Provider business mailing address
3576 SHALLOWFORD RD NE STE A
CHAMBLEE GA
30341-2998
US
V. Phone/Fax
- Phone: 770-451-9940
- Fax:
- Phone: 770-451-9940
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | RN246714 |
| License Number State | GA |
VIII. Authorized Official
Name:
LINA
ZHU
Title or Position: MANAGER
Credential:
Phone: 770-451-9940