Healthcare Provider Details

I. General information

NPI: 1366952475
Provider Name (Legal Business Name): ASHLEY DEANNE CUTINI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW BLDG 775TH
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

55 WHITCHER ST NE STE 460
MARIETTA GA
30060-1171
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-4600
  • Fax:
Mailing address:
  • Phone: 770-427-7389
  • Fax: 770-427-1492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN186411
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberRN186411
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: