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General NPI Number Information
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NPI Number | 1205375862
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Entity Type | Organization
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Legal Business Name | U-FIRST HEALTHCARE LLC
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Dates
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Enumeration Date | 02/15/2017
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 4228 1ST AVE STE 1
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City | TUCKER
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State | GA
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Zip | 30084-4426
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Country | US
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Telephone | 833-583-4778
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Fax | 833-583-4779
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Provider Business Mailing Address
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Address Line | 4228 1ST AVE STE 1
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City | TUCKER
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State | GA
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Zip | 30084-4426
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Country | US
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Telephone | 833-583-4778
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Fax | 833-583-4779
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Authorized Official
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Title or Position | CEO
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Name | DOROTHY CRISOSTOMO
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Credential |
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Telephone | 678-908-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | RN141244
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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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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