Healthcare Provider Details

I. General information

NPI: 1659169175
Provider Name (Legal Business Name): 4U HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 E 4TH AVE STE C
CORDELE GA
31015-0614
US

IV. Provider business mailing address

415 E 4TH AVE STE C
CORDELE GA
31015-0614
US

V. Phone/Fax

Practice location:
  • Phone: 478-953-0024
  • Fax:
Mailing address:
  • Phone: 229-273-9320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JULIE NOBLES
Title or Position: BILLING MANAGER
Credential:
Phone: 478-953-0024