Healthcare Provider Details

I. General information

NPI: 1073045829
Provider Name (Legal Business Name): ALESSANDRA ESNARD FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 COLISEUM DR
MACON GA
31217-0104
US

IV. Provider business mailing address

535 COLISEUM DR
MACON GA
31217-0104
US

V. Phone/Fax

Practice location:
  • Phone: 478-226-4086
  • Fax: 478-226-4113
Mailing address:
  • Phone: 478-226-4086
  • Fax: 478-226-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN288421
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: