Provider Information for 1194398784
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ANDJIE NNEKA CHERICHEL
Sex: Female
NPI: 1194398784
Last Updated: 2023-04-20
Certification Date: 2023-04-20
Certification Date: 2023-04-20
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1194398784 | ||||||||||||
| Enumeration Date | 2021-07-21 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 56 COTTON TAIL LN VILLA RICA, GA 30180-7271 United States Phone: 301-204-6749 | Fax: | ||||||||||||
| Primary Practice Address | 122 GORDON COMMERCIAL DR STE C LAGRANGE, GA 30240-5754 United States Phone: 301-204-6749 | Fax: | ||||||||||||
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