Healthcare Provider Details

I. General information

NPI: 1326696642
Provider Name (Legal Business Name): CODY JAMES FRANKLIN AGACNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 HOSPITAL BLVD STE 310
ROSWELL GA
30076-4947
US

IV. Provider business mailing address

2500 HOSPITAL BLVD STE 310
ROSWELL GA
30076-4947
US

V. Phone/Fax

Practice location:
  • Phone: 770-664-9600
  • Fax: 770-664-9856
Mailing address:
  • Phone: 770-664-9600
  • Fax: 770-664-9856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number248583
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN248583
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: