Healthcare Provider Details

I. General information

NPI: 1942670187
Provider Name (Legal Business Name): SUSAN MARIE ALMEIDA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 NORTHSIDE BLVD SUITE 4600
CUMMING GA
30041-7623
US

IV. Provider business mailing address

5955 WORTHINGTON CT
CUMMING GA
30040
US

V. Phone/Fax

Practice location:
  • Phone: 770-205-5292
  • Fax:
Mailing address:
  • Phone: 770-880-1147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN206603
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN206603
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: