Healthcare Provider Details

I. General information

NPI: 1750319240
Provider Name (Legal Business Name): BARBARA CAROL SUTTON RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 CLAIRMONT RD
DECATUR GA
30033-4004
US

IV. Provider business mailing address

1670 CLAIRMONT RD
DECATUR GA
30033-4004
US

V. Phone/Fax

Practice location:
  • Phone: 404-235-3023
  • Fax: 404-417-1519
Mailing address:
  • Phone: 404-235-3023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN157622
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: