Healthcare Provider Details
I. General information
NPI: 1861316572
Provider Name (Legal Business Name): MOTHERNURTURE MATERNITY ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4901 OLDE TOWNE PKWY STE 303
MARIETTA GA
30068-5644
US
IV. Provider business mailing address
4550 BRYN MAWR CIR NW
ATLANTA GA
30327-3519
US
V. Phone/Fax
- Phone: 404-908-7565
- Fax:
- Phone: 404-908-7565
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TAMEEKA
LAW
WALKER
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 404-908-7565