Healthcare Provider Details

I. General information

NPI: 1902379894
Provider Name (Legal Business Name): JOY A NWAFOR-AKOBUNDU NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2019
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 DEKALB MEDICAL PKWY
LITHONIA GA
30058-4996
US

IV. Provider business mailing address

1330 WALNUT HILL CIR
LAWRENCEVILLE GA
30043-8696
US

V. Phone/Fax

Practice location:
  • Phone: 404-501-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberPMH07250088
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberF02180610
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: