Healthcare Provider Details

I. General information

NPI: 1356146237
Provider Name (Legal Business Name): DWELLING PLACE PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2025
Last Update Date: 02/15/2025
Certification Date: 02/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL STE N
ATLANTA GA
30350-2995
US

IV. Provider business mailing address

8735 DUNWOODY PL STE N
ATLANTA GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 678-405-9363
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LADY COLLINS
Title or Position: OWNER
Credential:
Phone: 678-405-9363