Healthcare Provider Details

I. General information

NPI: 1699705954
Provider Name (Legal Business Name): AIMEE E DOTSON-MANION RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD
DECATUR GA
30033-4004
US

IV. Provider business mailing address

1210 CUMBERLAND CREEK PL SW
MARIETTA GA
30008-4493
US

V. Phone/Fax

Practice location:
  • Phone: 404-417-2978
  • Fax:
Mailing address:
  • Phone: 678-230-4406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License NumberRN164799
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: