Healthcare Provider Details

I. General information

NPI: 1356942247
Provider Name (Legal Business Name): FELICIA COLTON GOGGINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2020
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1267 HIGHWAY 54 W STE 2200
FAYETTEVILLE GA
30214-2110
US

IV. Provider business mailing address

PO BOX 116116
ATLANTA GA
30368-6116
US

V. Phone/Fax

Practice location:
  • Phone: 770-716-0051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN201535
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberRN201535
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: