Unknown Individual – Pediatric Nurse Practitioner, NPI 1083721617

Unknown Individual is a healthcare provider. based in Lawrenceville, Georgia. specializing in Pediatric Nurse Practitioner. They hold a License No. 33891 (GA). The NPI Number for Unknown Individual is 1083721617

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083721617
Phone
(770) 921-7386
Address
3685 LAWRENCEVILLE HWY
Deactivation Date
14 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • Lawrenceville Highway, Hanarry Estates, Lawrenceville, Gwinnett County, Georgia, 30046, United States

    SUITE 100

    LAWRENCEVILLE, GA 300444107

    Phone: (770) 921-7386

    Fax: (770) 381-6013

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30044)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1083721617.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Pediatric Nurse Practitioner is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Lawrenceville, Georgia as a primary anchor for Unknown Individual unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

Similar Providers

ROBIN NADINE EPSTEIN (NP)

Pediatric Nurse Practitioner
738 OLD NORCROSS RD
NPI: 1447209317

ANN SNYDER (CPNP)

Pediatric Nurse Practitioner
Providence Run Way, Providence Plantation, Lawrenceville, Gwinnett County, Georgia, 30046, United States
NPI: 1366491771

LORI G ROBERTS (CPNP)

Pediatric Nurse Practitioner
Lawrenceville Highway, Lawrenceville, Gwinnett County, Georgia, 30084, United States
NPI: 1033128004

STACY B BUCHANAN (RN, MS, CPNP)

Pediatric Nurse Practitioner
Lawrenceville Highway, Lawrenceville, Gwinnett County, Georgia, 30084, United States
NPI: 1497764476

SANDRA BOYLES (C.P. N. P.)

Pediatric Nurse Practitioner
Lawrenceville Highway, Hanarry Estates, Lawrenceville, Gwinnett County, Georgia, 30046, United States
NPI: 1518073147
595 HURRICANE SHOALS ROAD NW
NPI: 1699815738

MS. LESLIE BISHOP (NP)

Pediatric Nurse Practitioner
1170 ACACIA CT
NPI: 1750500625

TASHEEKA N WILLIAMS (CPNP)

Pediatric Nurse Practitioner
1405, Franklin Gateway Southeast, Marietta, Cobb, Georgia, 30067, United States
NPI: 1699944355

MARY ELIZABETH SMITH (CPNP)

Pediatric Nurse Practitioner
980 LAWRENCEVILLE HWY
NPI: 1730408386