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General NPI Number Information
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NPI Number | 1437664497
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Entity Type | Individual
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Provider Name | MS. GAIL MARIE GREGORIO ADJANASUKNART
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Gender | Female
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Dates
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Enumeration Date | 12/12/2017
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 780 CANTON RD NE STE 200
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City | MARIETTA
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State | GA
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Zip | 30060-7242
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Country | US
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Telephone | 404-260-5151
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Fax |
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Provider Business Mailing Address
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Address Line | 750 ECHO ST NW APT 1635
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City | ATLANTA
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State | GA
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Zip | 30318-6757
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Country | US
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Telephone | 404-697-5529
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN212246
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN212246
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License Number State | GA
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