MEDICARE: ABRAHAM ASIS

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	163WG0000X	General Practice Registered Nurse	RN326086	GA

General Provider Information

NPI Number	:	1740123033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABRAHAM ASIS

Provider Business Mailing Address
First Line	:	1000 ETOWAH FERRY DR APT 1416
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30102-1767
Country	:	US
Telephone Number	:	706-351-7762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 ETOWAH FERRY DR APT 1416
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30102-1767
Country	:	US
Telephone Number	:	706-351-7762
Fax Number	:

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

Provider Enumeration Date	:	04/11/2026
Last Update Date	:	04/11/2026

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Directions to “ ABRAHAM ASIS ” Practice Location

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