Healthcare Provider Details

I. General information

NPI: 1982072617
Provider Name (Legal Business Name): SHEILA LOUISSAINT LAFORTUNE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2015
Last Update Date: 11/08/2023
Certification Date: 11/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7094 PEACHTREE INDUSTRIAL BLVD STE 170-2
PEACHTREE CORNERS GA
30071-1024
US

IV. Provider business mailing address

7094 PEACHTREE INDUSTRIAL BLVD STE 170-2
PEACHTREE CORNERS GA
30071-1024
US

V. Phone/Fax

Practice location:
  • Phone: 470-775-9896
  • Fax: 404-439-9352
Mailing address:
  • Phone: 470-775-9896
  • Fax: 470-775-9896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number273137
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License Number273137
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number273137
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: