Healthcare Provider Details

I. General information

NPI: 1740193911
Provider Name (Legal Business Name): FAUZIA HOQUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 PARKLAKE DR NE STE 518
ATLANTA GA
30345-2995
US

IV. Provider business mailing address

2274 SPENCERS WAY
STONE MOUNTAIN GA
30087-1247
US

V. Phone/Fax

Practice location:
  • Phone: 678-656-2232
  • Fax: 678-623-5662
Mailing address:
  • Phone: 404-883-7191
  • Fax: 678-623-5662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP281928
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: