MEDICARE: ALLYSON CAROLINE HNATH PNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	RN281113	GA

General Provider Information

NPI Number	:	1417525684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLYSON CAROLINE HNATH PNP

Provider Business Mailing Address
First Line	:	2690 HILLANDALE CIR
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-6331
Country	:	US
Telephone Number	:	404-502-9798
Fax Number	:

Provider Business Practice Location Address
First Line	:	7165 COLFAX AVE
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-3027
Country	:	US
Telephone Number	:	678-990-3362
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2021
Last Update Date	:	01/16/2024

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