Healthcare Provider Details

I. General information

NPI: 1174919203
Provider Name (Legal Business Name): NGOZI ORABUEZE APRN-FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2015
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2049 METROPOLITAN PKWY SW
ATLANTA GA
30315-5926
US

IV. Provider business mailing address

2449 TOLLIVER DR
ELLENWOOD GA
30294-1235
US

V. Phone/Fax

Practice location:
  • Phone: 770-329-7339
  • Fax: 404-963-1300
Mailing address:
  • Phone: 770-329-7339
  • Fax: 404-963-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number2021183646
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN204864
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2021183646
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: