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General NPI Number Information
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NPI Number | 1144072273
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Entity Type | Individual
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Provider Name | DAISY MELINDA KING-GODINEAUX FNP
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Gender | Female
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Dates
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Enumeration Date | 04/02/2024
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 4760 AUSTELL RD STE 1&3
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City | AUSTELL
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State | GA
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Zip | 30106-2007
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Country | US
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Telephone | 678-464-4636
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Fax |
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Provider Business Mailing Address
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Address Line | 653 ROBERTS DR STE 84
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City | RIVERDALE
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State | GA
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Zip | 30274-2959
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Country | US
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Telephone | 678-361-2100
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN129544
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 163WN0300X
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Taxonomy Name | Nephrology Registered Nurse
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License Number | RN129544
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN129544
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN129544
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | RN129544
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN129544
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 163WD1100X
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Taxonomy Name | Peritoneal Dialysis Registered Nurse
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License Number | RN129544
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN129544
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 163WH0500X
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Taxonomy Name | Hemodialysis Registered Nurse
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License Number | RN129544
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 163WP0000X
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Taxonomy Name | Pain Management Registered Nurse
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License Number | RN129544
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License Number State | GA
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