Healthcare Provider Details

I. General information

NPI: 1255670709
Provider Name (Legal Business Name): DIANA CUADRADO-BARRERA NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3369 BUFORD HWY NE SUITE 810
ATLANTA GA
30329-3722
US

IV. Provider business mailing address

3369 BUFORD HWY NE SUITE 810
ATLANTA GA
30329-3722
US

V. Phone/Fax

Practice location:
  • Phone: 404-321-4692
  • Fax:
Mailing address:
  • Phone: 404-321-4692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN220894
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: