MEDICARE: MRS. JOANNA WILSON SUTHERLAND NP

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	RN110992	GA

General Provider Information

NPI Number	:	1912994690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANNA WILSON SUTHERLAND NP

Provider Business Mailing Address
First Line	:	333 COMMERCE ST STE 700
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37201-1835
Country	:	US
Telephone Number	:	615-454-9850
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 ABERNATHY RD STE 1700
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-5671
Country	:	US
Telephone Number	:	770-325-0636
Fax Number	:	855-737-5542

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

Provider Enumeration Date	:	09/29/2005
Last Update Date	:	03/17/2018

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