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General NPI Number Information
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NPI Number | 1093425563
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Entity Type | Organization
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Legal Business Name | MODERN HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 11/25/2022
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Last Update Date | 11/25/2022
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Provider Practice Location Address
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Address Line | 7943 HAWKS NEST TRL
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-7821
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Country | US
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Telephone | 678-209-9338
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Fax |
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Provider Business Mailing Address
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Address Line | 7943 HAWKS NEST TRL
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-7821
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Country | US
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Telephone | 678-209-9338
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Fax |
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Authorized Official
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Title or Position | DR. MADGALENE OZIWO
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Name | MAGDALENE OZIWO
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Credential | FNP-DNP
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Telephone | 678-209-9338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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