Healthcare Provider Details

I. General information

NPI: 1760771588
Provider Name (Legal Business Name): ALISON PEDEN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 GI MADDOX PKWY
CHATSWORTH GA
30705-4008
US

IV. Provider business mailing address

800 GI MADDOX PKWY
CHATSWORTH GA
30705-4008
US

V. Phone/Fax

Practice location:
  • Phone: 706-695-1992
  • Fax: 866-348-6516
Mailing address:
  • Phone: 706-695-1992
  • Fax: 866-348-6516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP181612
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: