MEDICARE: FATU SECKA FNP-C

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	363LF0000X	Family Nurse Practitioner	APRN-NP291821	GA

General Provider Information

NPI Number	:	1578259701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATU SECKA FNP-C

Provider Business Mailing Address
First Line	:	3194 BUFORD HWY
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-3386
Country	:	US
Telephone Number	:	470-649-3902
Fax Number	:

Provider Business Practice Location Address
First Line	:	3194 BUFORD HWY
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-3386
Country	:	US
Telephone Number	:	470-649-3902
Fax Number	:

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

Provider Enumeration Date	:	04/12/2023
Last Update Date	:	10/29/2025

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