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General NPI Number Information
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NPI Number | 1538416748
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Entity Type | Individual
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Provider Name | NICOLE RENEE STALLINGS CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 09/19/2024
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Provider Practice Location Address
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Address Line | 1800 HOWELL MILL RD NW STE 500
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City | ATLANTA
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State | GA
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Zip | 30318-2594
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Country | US
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Telephone | 404-367-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 2450 W HUNTING PARK AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1302
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Country | US
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Telephone | 215-707-4600
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Fax | 215-707-4034
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN305661
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP012160
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License Number State | PA
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