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General NPI Number Information
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NPI Number | 1619510740
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Entity Type | Individual
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Provider Name | TAURUS RAFEAL WOMBLE NP-C
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Gender | Male
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 3950 AUSTELL RD
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City | AUSTELL
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State | GA
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Zip | 30106-1121
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Country | US
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Telephone | 470-732-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2957 PEBBLE LN
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City | SNELLVILLE
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State | GA
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Zip | 30078-2754
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Country | US
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Telephone | 404-319-9664
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP222710
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License Number State | GA
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