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General NPI Number Information
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NPI Number | 1730979840
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Entity Type | Individual
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Provider Name | SHREYA PATEL AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 1468 MONTREAL RD
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City | TUCKER
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State | GA
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Zip | 30084-6901
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Country | US
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Telephone | 770-638-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 440 SIMONTON CREST DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-3510
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Country | US
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Telephone | 678-665-3583
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | RN306905
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License Number State | GA
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