Healthcare Provider Details

I. General information

NPI: 1174442958
Provider Name (Legal Business Name): MICHELLE SCOTT DOOLITTLE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 N CHASE ST
ATHENS GA
30601-1850
US

IV. Provider business mailing address

139 DOVE FIELD DR
STATHAM GA
30666-2476
US

V. Phone/Fax

Practice location:
  • Phone: 706-227-2110
  • Fax: 706-227-2116
Mailing address:
  • Phone: 706-680-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN251070
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP251070
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: