Healthcare Provider Details

I. General information

NPI: 1245142256
Provider Name (Legal Business Name): SYDNEY DONOHUE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2941 PIEDMONT RD NE STE C
ATLANTA GA
30305-2784
US

IV. Provider business mailing address

421 FLINTROCK WAY
WOODSTOCK GA
30188-2663
US

V. Phone/Fax

Practice location:
  • Phone: 404-602-0376
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number283865
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: