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General NPI Number Information
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NPI Number | 1316947427
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Entity Type | Individual
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Provider Name | NANCY A ILGENFRITZ NP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1140 HAMMOND DR NE SUITE E 5250
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City | ATLANTA
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State | GA
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Zip | 30328-5338
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Country | US
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Telephone | 404-256-2688
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Fax | 404-256-1820
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Provider Business Mailing Address
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Address Line | 333 SANDY SPRINGS CIR NE SUITE 207
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City | ATLANTA
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State | GA
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Zip | 30328-3897
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Country | US
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Telephone | 404-705-8990
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Fax | 404-705-9984
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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 | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | RN047165
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License Number State | GA
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