Healthcare Provider Details

I. General information

NPI: 1902731987
Provider Name (Legal Business Name): GARCIA ABRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 CLAIRMONT RD NE
BROOKHAVEN GA
30329-1044
US

IV. Provider business mailing address

2511 LONGCOURT CIR SE
ATLANTA GA
30339-1796
US

V. Phone/Fax

Practice location:
  • Phone: 404-315-4100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN-NP324237
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN-NP324237
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: