Healthcare Provider Details

I. General information

NPI: 1982568556
Provider Name (Legal Business Name): PATRICK NUGENT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3005 BRECKINRIDGE BLVD STE 230
DULUTH GA
30096-4978
US

IV. Provider business mailing address

1645 BROADWELL OAKS DR
ALPHARETTA GA
30004-1585
US

V. Phone/Fax

Practice location:
  • Phone: 404-224-9346
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: