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General NPI Number Information
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NPI Number | 1679181168
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Entity Type | Organization
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Legal Business Name | GUARDIAN HEALTH GROUP
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 08/04/2024
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Provider Practice Location Address
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Address Line | 4228 1ST AVE STE 1A
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City | TUCKER
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State | GA
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Zip | 30084-4426
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Country | US
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Telephone | 866-939-9929
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Fax | 470-761-4181
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Provider Business Mailing Address
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Address Line | 4228 1ST AVE STE 1A
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City | TUCKER
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State | GA
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Zip | 30084-4426
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Country | US
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Telephone | 866-939-9929
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Fax | 470-761-4181
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Authorized Official
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Title or Position | NP
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Name | MISS MARIE-ANDREE PARENT
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Credential | NURSE PRACTITIONER
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Telephone | 516-647-1557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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