Healthcare Provider Details

I. General information

NPI: 1093976664
Provider Name (Legal Business Name): ALICIA M PRICE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7395 OLD RICO RD
CHATTAHOOCHEE HILLS GA
30268-2066
US

IV. Provider business mailing address

1486 HIGHWAY 74 N UNIT 107
TYRONE GA
30290-1661
US

V. Phone/Fax

Practice location:
  • Phone: 704-378-9673
  • Fax:
Mailing address:
  • Phone: 646-918-0085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF306046
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN171017
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR212315
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: