Healthcare Provider Details

I. General information

NPI: 1962326173
Provider Name (Legal Business Name): NUVANA WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 W PEACHTREE ST NW STE 1910
ATLANTA GA
30309-2923
US

IV. Provider business mailing address

1920 DRESDEN DR NE # 190068
BROOKHAVEN GA
30319-3634
US

V. Phone/Fax

Practice location:
  • Phone: 404-620-5071
  • Fax:
Mailing address:
  • Phone: 404-620-5071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. TOCCARA HAYNES
Title or Position: OWNER
Credential: NP
Phone: 404-620-5071