=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245004902
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BHAVIKA B PATEL MSN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2023
-----------------------------------------------------
Last Update Date | 03/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 CEDARTOWN ST SW
-----------------------------------------------------
City | CAVE SPRING
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30124-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-749-4900
-----------------------------------------------------
Fax | 706-749-4901
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 CEDARTOWN ST SW
-----------------------------------------------------
City | CAVE SPRING
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30124-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-749-4900
-----------------------------------------------------
Fax | 706-749-4901
-----------------------------------------------------
=====================================================
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 | NP711395
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 0000035027
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------