Healthcare Provider Details

I. General information

NPI: 1790859536
Provider Name (Legal Business Name): LING QIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3850 WINDERMERE PKWY STE 105
CUMMING GA
30041-7033
US

IV. Provider business mailing address

3850 WINDERMERE PKWY STE 105
CUMMING GA
30041-7033
US

V. Phone/Fax

Practice location:
  • Phone: 678-455-2800
  • Fax: 770-888-9998
Mailing address:
  • Phone: 678-455-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License NumberRN143497
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN143497
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN143497
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN143497
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: