Healthcare Provider Details

I. General information

NPI: 1013253103
Provider Name (Legal Business Name): AMY MARIE WHEELER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2012
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 MOUNTAINSIDE VILLAGE PKWY BLDG 500
JASPER GA
30143-8694
US

IV. Provider business mailing address

3280 HOWELL MILL RD NW STE T100
ATLANTA GA
30327-4122
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-3200
  • Fax: 404-350-8795
Mailing address:
  • Phone: 404-355-3200
  • Fax: 404-350-8795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN165493
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: