Healthcare Provider Details

I. General information

NPI: 1164935326
Provider Name (Legal Business Name): SALINA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2017
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1711 TULLIE CIR NE
ATLANTA GA
30329-2305
US

IV. Provider business mailing address

1711 TULLIE CIR
ATLANTA GA
30329-2305
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-5413
  • Fax:
Mailing address:
  • Phone: 404-785-5413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberRN271320
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: