Healthcare Provider Details

I. General information

NPI: 1518104348
Provider Name (Legal Business Name): ELAINE F PHELPS R.N.,C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELAINE F GRANGER R.N.,C.N.P.

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE
ATLANTA GA
30308-2208
US

IV. Provider business mailing address

68 LITTLE CREEK DR
JASPER GA
30143-6386
US

V. Phone/Fax

Practice location:
  • Phone: 404-686-6730
  • Fax:
Mailing address:
  • Phone: 404-583-5552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN116530
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberRN116530NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: