Healthcare Provider Details

I. General information

NPI: 1962224139
Provider Name (Legal Business Name): NADIA NOEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 ENTERPRISE PATH STE 104
HIRAM GA
30141-2655
US

IV. Provider business mailing address

59 CRESTBROOK WAY
DALLAS GA
30157-1463
US

V. Phone/Fax

Practice location:
  • Phone: 678-990-1270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP303095
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN303095
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: