Healthcare Provider Details

I. General information

NPI: 1528643921
Provider Name (Legal Business Name): CHRISTIAN HAINEY BOHNSTEDT FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11975 MORRIS RD STE 200
ALPHARETTA GA
30005-4444
US

IV. Provider business mailing address

5780 PEACHTREE DUNWOODY RD STE 300
ATLANTA GA
30342-1513
US

V. Phone/Fax

Practice location:
  • Phone: 770-751-3600
  • Fax: 770-751-3615
Mailing address:
  • Phone: 404-303-8035
  • Fax: 404-303-1325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN261966
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: