Healthcare Provider Details

I. General information

NPI: 1265948178
Provider Name (Legal Business Name): GINGER MCINTOSH CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2017
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 POST OAK TRITT RD STE 100
MARIETTA GA
30062-1651
US

IV. Provider business mailing address

2155 POST OAK TRITT RD STE 100
MARIETTA GA
30062-1651
US

V. Phone/Fax

Practice location:
  • Phone: 770-973-4700
  • Fax: 770-565-0326
Mailing address:
  • Phone: 770-973-4700
  • Fax: 770-565-0326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberRN198695
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: