Unknown Individual – Pediatric Nurse Practitioner, NPI 1164464699
Pediatric Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1807 SEPTEMBER WAY
DOUGLASVILLE, GA 301351194
Phone: (404) 966-2679
Type: Mailing
Clifton Road Northeast, Candler Park, Druid Hills, DeKalb County, Georgia, 30329, United States
ATLANTA, GA 303224008
Phone: (404) 785-6465
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30135)
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