Healthcare Provider Details

I. General information

NPI: 1851147011
Provider Name (Legal Business Name): JULIA REBECCA GRIFFIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ENOTA DR NE STE 100
GAINESVILLE GA
30501-3466
US

IV. Provider business mailing address

200 S ENOTA DR NE STE 100
GAINESVILLE GA
30501-3466
US

V. Phone/Fax

Practice location:
  • Phone: 770-599-2366
  • Fax:
Mailing address:
  • Phone: 770-534-2020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN295099
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: