Healthcare Provider Details

I. General information

NPI: 1255212262
Provider Name (Legal Business Name): DONNA MOBLEY RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606-2797
US

IV. Provider business mailing address

2930 SNOWS MILL RD
MONROE GA
30655-5078
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-1870
  • Fax:
Mailing address:
  • Phone: 706-475-1870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number267702
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: