Healthcare Provider Details

I. General information

NPI: 1821195819
Provider Name (Legal Business Name): SHEILA FOARDE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5671 PEACHTREE DUNWOODY RD STE 620
ATLANTA GA
30342-5006
US

IV. Provider business mailing address

5260 WYNTERCREEK WAY
DUNWOODY GA
30338
US

V. Phone/Fax

Practice location:
  • Phone: 678-369-5454
  • Fax: 678-369-5455
Mailing address:
  • Phone: 770-393-8186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN155984
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: