Healthcare Provider Details

I. General information

NPI: 1700687274
Provider Name (Legal Business Name): CHENA YVONNE ALLEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5095 MOUNT ZION PKWY
STOCKBRIDGE GA
30281-7825
US

IV. Provider business mailing address

950 EAGLES LANDING PKWY # 746
STOCKBRIDGE GA
30281-7343
US

V. Phone/Fax

Practice location:
  • Phone: 770-507-0576
  • Fax:
Mailing address:
  • Phone: 404-939-0522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF02250353
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: