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General NPI Number Information
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NPI Number | 1205182102
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Entity Type | Individual
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Provider Name | GINA TOULON NP
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Gender | Female
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Dates
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Enumeration Date | 07/28/2012
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 59 EXECUTIVE PARK S
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City | ATLANTA
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State | GA
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Zip | 30329-2208
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Country | US
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Telephone | 404-778-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 5521 STONE CUTTER DR
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City | STONECREST
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State | GA
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Zip | 30038-1254
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Country | US
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Telephone | 631-278-1819
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN241097
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License Number State | GA
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