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General NPI Number Information
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NPI Number | 1447134168
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Entity Type | Organization
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Legal Business Name | THRIVE WOUND RECOVERY, PC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 311 NELSON ST SW STE 16121
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City | ATLANTA
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State | GA
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Zip | 30313-1354
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Country | US
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Telephone | 229-630-2001
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Fax | 229-231-3089
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Provider Business Mailing Address
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Address Line | 5539 TIMBERWIND CIR
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City | LAKE PARK
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State | GA
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Zip | 31636-2888
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Country | US
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Telephone | 229-630-2001
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ZAKIYYAH VASHE WEATHERSPOON
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Credential | FNP-BC, PMHNP-BC
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Telephone | 229-630-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #4
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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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