Healthcare Provider Details

I. General information

NPI: 1558018952
Provider Name (Legal Business Name): JULIA GRACE CARTWRIGHT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 CHEROKEE ST NE STE 100
MARIETTA GA
30060-8930
US

IV. Provider business mailing address

4302 BRITT RD
TUCKER GA
30084-1401
US

V. Phone/Fax

Practice location:
  • Phone: 678-797-8201
  • Fax:
Mailing address:
  • Phone: 404-405-9102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN297460
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: