Healthcare Provider Details

I. General information

NPI: 1164571428
Provider Name (Legal Business Name): RHONDA L LIGON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 DAVINCI CT SUITE 400
NORCROSS GA
30092-7627
US

IV. Provider business mailing address

1400 LANDON DR
LOCUST GROVE GA
30248-2462
US

V. Phone/Fax

Practice location:
  • Phone: 770-582-3972
  • Fax: 770-582-4189
Mailing address:
  • Phone: 678-432-9277
  • Fax: 770-582-4189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN085485NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: