Healthcare Provider Details

I. General information

NPI: 1821556770
Provider Name (Legal Business Name): SHANICE LANIE FIGUEROA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2019
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2045 PEACHTREE RD NE STE 410
ATLANTA GA
30309-1408
US

IV. Provider business mailing address

5901 W CENTURY BLVD STE 750
LOS ANGELES CA
90045-5443
US

V. Phone/Fax

Practice location:
  • Phone: 310-496-5844
  • Fax:
Mailing address:
  • Phone: 678-477-6952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN236820
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN236820
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: