=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083931042
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADRIANA ESPINOSA R.N.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2010
-----------------------------------------------------
Last Update Date | 04/29/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6020 DAWSON BLVD SUITE I
-----------------------------------------------------
City | NORCROSS
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30093-1225
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-662-0249
-----------------------------------------------------
Fax | 770-449-5023
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 55 PHARR RD NW APT D101
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30305-2149
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-662-0249
-----------------------------------------------------
Fax | 770-449-5023
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN206035
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------