Healthcare Provider Details

I. General information

NPI: 1376488593
Provider Name (Legal Business Name): ABIGAIL ELIZABETH LAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6918 MCGINNIS FERRY RD STE 200
SUWANEE GA
30024-1258
US

IV. Provider business mailing address

2805 CREEK TREE LN
CUMMING GA
30041-6308
US

V. Phone/Fax

Practice location:
  • Phone: 770-622-5758
  • Fax:
Mailing address:
  • Phone: 678-995-6991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN327022
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: