Healthcare Provider Details

I. General information

NPI: 1699105254
Provider Name (Legal Business Name): LINDA HSU FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 03/28/2020
Certification Date: 03/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5461 BUFORD HWY NE
ATLANTA GA
30340-1124
US

IV. Provider business mailing address

5461 BUFORD HWY NE
ATLANTA GA
30340-1124
US

V. Phone/Fax

Practice location:
  • Phone: 770-457-5556
  • Fax: 770-457-7776
Mailing address:
  • Phone: 770-457-5556
  • Fax: 770-457-7776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN206539
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: