=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194440883
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAMEKA NICOLE PATTERSON-BENTJEN CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2022
-----------------------------------------------------
Last Update Date | 11/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1265 HIGHWAY 54 W STE 305
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30214-4537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-719-5660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 960 JOHNSON FERRY RD STE 500
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30342-1630
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-257-0006
-----------------------------------------------------
Fax | 404-851-1316
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN-NP232402
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------