Healthcare Provider Details

I. General information

NPI: 1932856606
Provider Name (Legal Business Name): CHOYCE STEVENS COE CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2022
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3885 PRINCETON LAKES WAY SW STE 302
ATLANTA GA
30331-5590
US

IV. Provider business mailing address

3885 PRINCETON LAKES WAY SW STE 302
ATLANTA GA
30331-5590
US

V. Phone/Fax

Practice location:
  • Phone: 404-629-1880
  • Fax: 404-629-1923
Mailing address:
  • Phone: 404-629-1880
  • Fax: 404-629-1923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11026551
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberRN245083
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: