Healthcare Provider Details

I. General information

NPI: 1427005354
Provider Name (Legal Business Name): SUSAN E. AUSTIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2464 ROSWELL RD
MARIETTA GA
30062-4954
US

IV. Provider business mailing address

2020 21ST AVE S SUITE 201
NASHVILLE TN
37212-4354
US

V. Phone/Fax

Practice location:
  • Phone: 678-732-1500
  • Fax:
Mailing address:
  • Phone: 615-269-0652
  • Fax: 615-269-0135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberRN259939
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRN259939
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN259939
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: