Healthcare Provider Details

I. General information

NPI: 1295697134
Provider Name (Legal Business Name): A HEART OF A NURSE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2846 COVE VIEW CT
DACULA GA
30019-4705
US

IV. Provider business mailing address

2846 COVE VIEW CT
DACULA GA
30019-4705
US

V. Phone/Fax

Practice location:
  • Phone: 800-891-1550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MARTINE PAUL
Title or Position: ADMINISTRATOR
Credential: RN MSN
Phone: 800-891-1550