Healthcare Provider Details

I. General information

NPI: 1518550664
Provider Name (Legal Business Name): MARIE GUILDA VILMONT-RHEA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5610 WENDY BAGWELL PKWY
HIRAM GA
30141-7837
US

IV. Provider business mailing address

3197 CREEK TRCE W
POWDER SPRINGS GA
30127-9064
US

V. Phone/Fax

Practice location:
  • Phone: 770-943-7808
  • Fax:
Mailing address:
  • Phone: 470-442-5805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN258150
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN258150
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: