Healthcare Provider Details

I. General information

NPI: 1609500347
Provider Name (Legal Business Name): BEHRAZ ALIPOORABEDI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2022
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4444 AUSTELL RD
AUSTELL GA
30106-1844
US

IV. Provider business mailing address

4444 AUSTELL RD
AUSTELL GA
30106-1844
US

V. Phone/Fax

Practice location:
  • Phone: 678-460-2700
  • Fax: 877-784-4013
Mailing address:
  • Phone: 678-460-2700
  • Fax: 877-784-4013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN255454
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: