Healthcare Provider Details

I. General information

NPI: 1255468484
Provider Name (Legal Business Name): JEANNE INGRAHAM FELL PNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 BRIARCLIFF RD NE
ATLANTA GA
30329-4010
US

IV. Provider business mailing address

550 PEACHTREE ST NE
ATLANTA GA
30308-2212
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-9405
  • Fax: 404-785-9025
Mailing address:
  • Phone: 404-686-2694
  • Fax: 404-686-4631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN080116
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: