| Doctor Name: | GRETA GILSON AGNEW |
| NPI Number: | 1205257268 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP-BC |
| License Number: | RN054192 |
| Business Practice Address: | 5805 State Bridge Rd Suite G 237 Johns Creek, GA - 300978220 |
| Business Phone Number: | 7703301914 |
| Business Fax Number: | |
| Mailing Address: | 5805 State Bridge Rd, Suite G 237 JOHNS CREEK |
| State: | GA |
| Postal Code: | 300978220 |
| Phone Number: | 7703301914 |
| Fax Number: | |
| NPI Enumeration Date: | 12/18/2013 |
| NPI Last Update Date: | 12/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN054192 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |