Provider Demographics
NPI:1770318040
Name:ALLOMONG, MARJORIE HUTCHERSON (MSN, APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:MARJORIE
Middle Name:HUTCHERSON
Last Name:ALLOMONG
Suffix:
Gender:F
Credentials:MSN, APRN, CPNP-PC
Other - Prefix:
Other - First Name:MARJORIE
Other - Middle Name:ANN
Other - Last Name:HUTCHERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6015 STATE BRIDGE RD APT 5401
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-6494
Mailing Address - Country:US
Mailing Address - Phone:770-508-4822
Mailing Address - Fax:
Practice Address - Street 1:2575 PEACHTREE PKWY STE 301
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7563
Practice Address - Country:US
Practice Address - Phone:678-962-7337
Practice Address - Fax:844-662-3114
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN326581363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics