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General NPI Number Information
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NPI Number | 1477926509
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Entity Type | Organization
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Legal Business Name | UNITED HEALTHCARE
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 11/11/2015
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Provider Practice Location Address
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Address Line | 3820 BRIARCLIFF RD NE
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City | ATLANTA
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State | GA
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Zip | 30345-3857
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Country | US
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Telephone | 404-213-7548
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Fax |
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Provider Business Mailing Address
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Address Line | 3820 BRIARCLIFF RD NE
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City | ATLANTA
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State | GA
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Zip | 30345-3857
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Country | US
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Telephone | 404-213-7548
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MARILYN NURSE
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Credential | APRN
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Telephone | 404-846-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 363L00000X
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License Number State | GA
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