IndividualActive
Corwin Demattos
NPI 1720617756 · Family Nurse Practitioner · Grayson, GA
Provider details
- NPI number
- 1720617756
- Entity type
- Individual
- Primary specialty
- Family Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 189365 (GA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1637 Atlanta Hwy Suite a
Grayson, GA 30017-3001
Phone: (678) 344-8268
Approximate (ZIP-level) locationGet directions
Mailing address
1637 Atlanta Hwy Suite a
Grayson, GA 30017-5942
Registry dates
- Enumerated
- 2020-04-02
- Last updated
- 2021-12-02
- Certified
- 2021-11-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.