Healthcare Provider Details

I. General information

NPI: 1386299253
Provider Name (Legal Business Name): GLENDA ANN SINCLAIR PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 SCENIC HWY
LAWRENCEVILLE GA
30046-5675
US

IV. Provider business mailing address

250 SCENIC HWY
LAWRENCEVILLE GA
30046-5675
US

V. Phone/Fax

Practice location:
  • Phone: 404-442-5800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN206984
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN206984
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: