Healthcare Provider Details
I. General information
NPI: 1407400427
Provider Name (Legal Business Name): RACHEL MAE PERLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/29/2019
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1584 TULLIE CIR NE
ATLANTA GA
30329-2311
US
IV. Provider business mailing address
1584 TULLIE CIR NE
ATLANTA GA
30329-2311
US
V. Phone/Fax
- Phone: 404-785-5413
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LN0005X |
| Taxonomy | Critical Care Neonatal Nurse Practitioner |
| License Number | RN140153 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: