=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154111987
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA KUMARY BHATIA MSN, APRN FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/06/2025
-----------------------------------------------------
Last Update Date | 05/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 960 SANDERS RD STE 500
-----------------------------------------------------
City | CUMMING
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30041-5978
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-321-7227
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1494 W NANCY CREEK DR NE
-----------------------------------------------------
City | BROOKHAVEN
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30319-1858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-535-9563
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN324429
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------