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NPI Code Detail

MEDICARE: MS. MAXINE ROCKHEAD FNP

MEDICARE:  MS. MAXINE  ROCKHEAD  FNP
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
1363LF0000XFamily Nurse PractitionerRN191053GA

General Provider Information

NPI Number : 1982057469
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MAXINE ROCKHEAD FNP
Provider Business Mailing Address
First Line : PO BOX 746063
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6063
Country : US
Telephone Number : 866-464-0875
Fax Number : 312-929-0373
Provider Business Practice Location Address
First Line : 1263 MORELAND AVE SE
Second Line :
City : ATLANTA
State : GA
Zip : 30316-3183
Country : US
Telephone Number : 470-444-3137
Fax Number : 470-202-3003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2016
Last Update Date : 09/16/2025

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Directions to “ MS. MAXINE ROCKHEAD FNP” Practice Location

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