Healthcare Provider Details

I. General information

NPI: 1073086898
Provider Name (Legal Business Name): SUSANA GARCIA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 07/12/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2324 LIMESTONE OVERLOOK
GAINESVILLE GA
30501-7443
US

IV. Provider business mailing address

619 LYNNFIELD DR
LAWRENCEVILLE GA
30045-5228
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-8109
  • Fax:
Mailing address:
  • Phone: 770-865-6865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN209709
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: