Healthcare Provider Details

I. General information

NPI: 1780519991
Provider Name (Legal Business Name): ELEXYA PRESLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 HARDEE AVE SW
ATLANTA GA
30310-5110
US

IV. Provider business mailing address

2723 LOST LAKES DR
POWDER SPRINGS GA
30127-6012
US

V. Phone/Fax

Practice location:
  • Phone: 404-230-5683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number1111084
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: