Healthcare Provider Details

I. General information

NPI: 1093621815
Provider Name (Legal Business Name): NAKIA WOODSON REALTOR WOODSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2557 HIGHTOWER CT NW
ATLANTA GA
30318-7436
US

IV. Provider business mailing address

2557 HIGHTOWER CT NW
ATLANTA GA
30318-7436
US

V. Phone/Fax

Practice location:
  • Phone: 702-318-1244
  • Fax:
Mailing address:
  • Phone: 712-318-1244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: