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General NPI Number Information
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NPI Number | 1689667933
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Entity Type | Individual
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Provider Name | ELISE PACITTI NP
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Gender | Female
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 10/24/2007
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Provider Practice Location Address
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Address Line | 790 CHURCH ST NE SUITE 250
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City | MARIETTA
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State | GA
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Zip | 30060-7282
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Country | US
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Telephone | 678-797-8201
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Fax | 678-290-8325
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Provider Business Mailing Address
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Address Line | 790 CHURCH ST NE SUITE 230
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City | MARIETTA
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State | GA
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Zip | 30060-7282
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Country | US
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Telephone | 678-797-8201
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Fax | 678-290-8325
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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 | 099451
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License Number State | GA
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