Healthcare Provider Details

I. General information

NPI: 1417812694
Provider Name (Legal Business Name): SHEENA PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 WINTER PARK LN
POWDER SPRINGS GA
30127-6791
US

IV. Provider business mailing address

421 WINTER PARK LN
POWDER SPRINGS GA
30127-6791
US

V. Phone/Fax

Practice location:
  • Phone: 404-563-2873
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN332932
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: