Healthcare Provider Details

I. General information

NPI: 1487968616
Provider Name (Legal Business Name): ANISHA N PATEL MSN, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 CURITIBA CT
ALPHARETTA GA
30022-1454
US

IV. Provider business mailing address

3450 CURITIBA CT
ALPHARETTA GA
30022-1454
US

V. Phone/Fax

Practice location:
  • Phone: 678-762-7080
  • Fax:
Mailing address:
  • Phone: 678-762-7080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN152463
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: