Healthcare Provider Details

I. General information

NPI: 1275053340
Provider Name (Legal Business Name): DEVEANE TATANYA ATKINSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEVEANE T. ATKINSON FNP

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 OLD MCDONOUGH HWY SE STE E
CONYERS GA
30094
US

IV. Provider business mailing address

3305 COLES CREEK DR
BUFORD GA
30519-7000
US

V. Phone/Fax

Practice location:
  • Phone: 770-922-9222
  • Fax:
Mailing address:
  • Phone: 678-779-6441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRNNP167706
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRNNP167706
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number167706
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: