Healthcare Provider Details

I. General information

NPI: 1811825672
Provider Name (Legal Business Name): GRACE DEANNA SIGMON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CUMBERLAND PKWY SE
ATLANTA GA
30339-3915
US

IV. Provider business mailing address

2525 CUMBERLAND PKWY SE
ATLANTA GA
30339-3915
US

V. Phone/Fax

Practice location:
  • Phone: 404-365-0966
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP301330
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: