Healthcare Provider Details

I. General information

NPI: 1205818044
Provider Name (Legal Business Name): NAMITA PATEL RN, CNS/PMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 COGGINS PL NE
MARIETTA GA
30060-2585
US

IV. Provider business mailing address

9095 CARROLL MANOR DR
SANDY SPRINGS GA
30350-2010
US

V. Phone/Fax

Practice location:
  • Phone: 404-822-6105
  • Fax:
Mailing address:
  • Phone: 404-822-6105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN145957
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: