Healthcare Provider Details

I. General information

NPI: 1609866482
Provider Name (Legal Business Name): RACHEL BURT CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5780 PEACHTREE DUNWOODY RD STE 195
ATLANTA GA
30342-1513
US

IV. Provider business mailing address

3934 ASHFORD TRL NE
BROOKHAVEN GA
30319-1897
US

V. Phone/Fax

Practice location:
  • Phone: 770-751-3600
  • Fax:
Mailing address:
  • Phone: 404-625-8492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN165332
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: