Healthcare Provider Details

I. General information

NPI: 1710311824
Provider Name (Legal Business Name): MARIE MICHELLE FRANCIS RN- PCHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 08/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5691 BOREAL WAY SW
ATLANTA GA
30331-9219
US

IV. Provider business mailing address

5691 BOREAL WAY SW
ATLANTA GA
30331-9219
US

V. Phone/Fax

Practice location:
  • Phone: 561-900-8274
  • Fax: 404-346-1237
Mailing address:
  • Phone: 561-900-8274
  • Fax: 404-346-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberPCH008199
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN194771
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberRN194771
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: