Healthcare Provider Details

I. General information

NPI: 1245004902
Provider Name (Legal Business Name): BHAVIKA B PATEL MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 CEDARTOWN ST SW
CAVE SPRING GA
30124-2703
US

IV. Provider business mailing address

15 CEDARTOWN ST SW
CAVE SPRING GA
30124-2703
US

V. Phone/Fax

Practice location:
  • Phone: 706-749-4900
  • Fax: 706-749-4901
Mailing address:
  • Phone: 706-749-4900
  • Fax: 706-749-4901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP711395
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0000035027
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: