| Doctor Name: | PETRA NOZILE |
| NPI Number: | 1043676380 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RN174065 |
| Business Practice Address: | 50 Kelly Rd Mcdonough, GA - 302536097 |
| Business Phone Number: | 7709571887 |
| Business Fax Number: | 7709576864 |
| Mailing Address: | 50 Kelly Rd, MCDONOUGH |
| State: | GA |
| Postal Code: | 302536097 |
| Phone Number: | 7709571887 |
| Fax Number: | 7709576864 |
| NPI Enumeration Date: | 12/31/2015 |
| NPI Last Update Date: | 01/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN174065 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |