Healthcare Provider Details

I. General information

NPI: 1598347106
Provider Name (Legal Business Name): VALENTINA AFE ASAMAIGOR PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10090 MEDLOCK BRIDGE RD STE 110
JOHNS CREEK GA
30097-4428
US

IV. Provider business mailing address

10090 MEDLOCK BRIDGE RD STE 110
JOHNS CREEK GA
30097-4428
US

V. Phone/Fax

Practice location:
  • Phone: 470-482-6508
  • Fax: 770-476-9750
Mailing address:
  • Phone: 470-482-6508
  • Fax: 770-476-9750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP229211
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN229211
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: