Provider Demographics
NPI:1235988528
Name:MONK, GEORGIANNA ROSE
Entity type:Individual
Prefix:MISS
First Name:GEORGIANNA
Middle Name:ROSE
Last Name:MONK
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:GEORGIA
Other - Middle Name:ROSE
Other - Last Name:MONK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4593 HANCOCK WAY SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-4263
Mailing Address - Country:US
Mailing Address - Phone:404-955-2187
Mailing Address - Fax:
Practice Address - Street 1:5665 PEACHTREE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1764
Practice Address - Country:US
Practice Address - Phone:678-843-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor