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Ebot B Manga
Family Nurse Practitioner in Dacula, Georgia
NPI 1164920716

Ebot B Manga is a Family Nurse Practitioner based in Dacula, GA and is specialized in Family. Ebot B Manga practices in Dacula, GA. The NPI Number for Ebot B Manga is 1164920716 and holds a License No. 147685 (Georgia).

The current practice location address for Ebot B Manga is 2064 Lilac Arbor Way, Dacula, GA and can be reached out via phone at 678-887-4367.

Location: 2064 Lilac Arbor Way, Dacula, GA, 30019-2475
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164920716
Provider Name
Ebot B Manga
Credential
Provider Entity Type
Individual
Gender
Male
Address
2064 Lilac Arbor Way, Dacula, GA, 30019-2475
Phone Number
678-887-4367
Fax Number
Provider Enumeration Date
01/29/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2064 Lilac Arbor Way
City
Dacula
State
Georgia
Zip
30019-2475
Phone Number
678-887-4367
Fax Number
person
Provider Business Mailing Address Details
Address
2064 Lilac Arbor Way
City
Dacula
State
Georgia
Zip
30019-2475
Phone Number
678-887-4367
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
147685 (Georgia)
Definition
Definition to come...
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