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General NPI Number Information
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NPI Number | 1164210589
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Entity Type | Organization
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Legal Business Name | EMAN HADDAD
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Dates
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Enumeration Date | 04/26/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 3215 SUMMER STREAM LN NW
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City | KENNESAW
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State | GA
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Zip | 30152-5883
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Country | US
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Telephone | 404-388-8136
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 WOODMONT LN NW # 1445
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | EMAN HADDAD
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Credential | APRN
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Telephone | 404-388-8136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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