Healthcare Provider Details
I. General information
NPI: 1134048465
Provider Name (Legal Business Name): NEO WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1341 MORELAND AVE SE STE 103
ATLANTA GA
30316-3127
US
IV. Provider business mailing address
1747 BOULDER WALK LN SE
ATLANTA GA
30316-3990
US
V. Phone/Fax
- Phone: 404-478-7807
- Fax: 404-738-2742
- Phone: 404-478-7807
- Fax: 404-738-2742
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LATONIA
MICHELLE
TRAWICK
Title or Position: NURSE PRACTITIONER
Credential: DNP FNP
Phone: 404-423-8158