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General NPI Number Information
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NPI Number | 1770334658
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Entity Type | Organization
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Legal Business Name | TEAMWORKS COMMUNITY HEALTH, LLC
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Dates
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Enumeration Date | 03/29/2024
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1775 PARKER RD SE STE C210
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City | CONYERS
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State | GA
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Zip | 30094-6676
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Country | US
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Telephone | 770-776-8280
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Fax |
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Provider Business Mailing Address
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Address Line | 1775 PARKER RD SE STE C210
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City | CONYERS
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State | GA
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Zip | 30094-6676
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Country | US
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Telephone | 770-776-8280
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | CRYSTAL BEDDARD
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Credential | DNP, PMHNP-BC, FNP-C
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Telephone | 770-776-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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