DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MIRA DESAI AGPCNP

MEDICARE: MIRA DESAI AGPCNP
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
1363LA2200XAdult Health Nurse PractitionerRN309281GA
2363LG0600XGerontology Nurse PractitionerAPRN03074RI
3363LG0600XGerontology Nurse Practitioner13875CT
4363LG0600XGerontology Nurse Practitioner0001299163VA
5363LG0600XGerontology Nurse Practitioner277.002161IL

General Provider Information

NPI Number : 1538559190
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIRA DESAI AGPCNP
Provider Business Mailing Address
First Line : PO BOX 746715
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6715
Country : US
Telephone Number : 773-352-1515
Fax Number : 312-929-0373
Provider Business Practice Location Address
First Line : 1825 ROCKBRIDGE RD STE 15B
Second Line :
City : STONE MOUNTAIN
State : GA
Zip : 30087-3306
Country : US
Telephone Number : 470-444-3134
Fax Number : 470-276-4370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2015
Last Update Date : 06/06/2025

Similar Medicare Providers

1376156562 — MRS. MONICA FAJOBI APRN, FNP-BC
Practice Location Address:
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
30087-3306
Practice Phone: 470-444-3134
Practice Fax: 470-276-4370
1497983639 — DR. NWAMAKA M ONUIGBO M. D.
Practice Location Address:
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
30087-3306
Practice Phone: 470-444-3134
Practice Fax: 470-273-4370
1841511797 — JOSE M DONATIEN MD
Practice Location Address:
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
30087-3306
Practice Phone: 470-444-3134
Practice Fax: 470-276-4370
1942592787 — FRENY SHAH M.D.
Practice Location Address:
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
30087-3306
Practice Phone: 470-444-3134
Practice Fax: 470-276-4370
1598197667 — KATHY PETRIE ANP
Practice Location Address:
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
30087-3306
Practice Phone: 470-444-3134
Practice Fax: 470-276-4370
1790197283 — MS. VIVIAN GAINES-THOMPSON N.P.
Practice Location Address:
1825 ROCKBRIDGE RD STE 15B
STONE MOUNTAIN, GA
30087-3306
Practice Phone: 470-444-3134
Practice Fax: 470-276-4370

Directions to “ MIRA DESAI AGPCNP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.