Healthcare Provider Details

I. General information

NPI: 1083369318
Provider Name (Legal Business Name): VIGOR HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2022
Last Update Date: 06/26/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 PARSONS RDG
JOHNS CREEK GA
30097-7713
US

IV. Provider business mailing address

300 COLONIAL CENTER PKWY STE 100
ALPHARETTA GA
30096-7713
US

V. Phone/Fax

Practice location:
  • Phone: 404-910-9499
  • Fax:
Mailing address:
  • Phone: 678-862-2513
  • Fax: 505-416-4814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE NNAMCHI
Title or Position: OWNER
Credential: PMHNP
Phone: 404-910-9499