Healthcare Provider Details

I. General information

NPI: 1821675901
Provider Name (Legal Business Name): REEMA CHEEMA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 03/25/2021
Certification Date: 03/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 NORTHSIDE PKWY NW STE 200
ATLANTA GA
30327-3007
US

IV. Provider business mailing address

4200 NORTHSIDE PKWY NW STE 200
ATLANTA GA
30327-3007
US

V. Phone/Fax

Practice location:
  • Phone: 404-881-8020
  • Fax:
Mailing address:
  • Phone: 404-881-8020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN251554
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN251554
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: