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General NPI Number Information
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NPI Number | 1174983696
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Entity Type | Individual
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Provider Name | SAMREEN BHIMANI I NP-C
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Gender | Female
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | FAMILY MEDICAL CLINIC OF LAWRENCEVILLE, LLC 2522 CRUSE ROAD SUITE C-2
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044
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Country | US
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Telephone | 678-225-5540
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Fax | 678-225-5541
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Provider Business Mailing Address
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Address Line | 1829 HEDGE ROSE DR NE
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City | ATLANTA
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State | GA
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Zip | 30324-2784
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Country | US
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Telephone | 404-201-0728
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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 | RN202217
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License Number State | GA
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