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Nurse Practioner
Point of Service in Kennesaw, Georgia
NPI 1629519202

Nurse Practioner is a Point of Service based in Powder Springs, GA. Nurse Practioner practices in Kennesaw, GA. The NPI Number for Nurse Practioner is 1629519202 and holds a License No. 193760 (Georgia).

The current practice location address for Nurse Practioner is 4044 George Busbee Pkwy Nw Apt 4207, Kennesaw, GA and can be reached out via phone at 404-579-1658.

Location: 4044 George Busbee Pkwy Nw Apt 4207, Kennesaw, GA, 30127-7234
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629519202
Provider Name
Nurse Practioner
Credential
Provider Entity Type
Organization
Address
4044 George Busbee Pkwy Nw Apt 4207, Kennesaw, GA, 30127-7234
Phone Number
404-579-1658
Fax Number
Provider Enumeration Date
03/15/2017
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
4044 George Busbee Pkwy Nw Apt 4207
City
Kennesaw
State
Georgia
Zip
30144-6890
Phone Number
404-579-1658
Fax Number
person
Provider Business Mailing Address Details
Address
4044 George Busbee Pkwy Nw Apt 4207
City
Kennesaw
State
Georgia
Zip
30144-6890
Phone Number
404-579-1658
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Community Health
Taxonomy
261QC1500X
License No.
193760 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Managed Care Organizations
Classification
Point of Service
Speciality
-
Taxonomy
305S00000X
License No.
193760 (Georgia)
Definition
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
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