=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770497620
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BAYBERRY HEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/29/2026
-----------------------------------------------------
Last Update Date | 09/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3181 GREENBRIER CT
-----------------------------------------------------
City | BUFORD
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30519-7808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-474-1059
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3300 HAMILTON MILL RD STE 102 PMB 1068
-----------------------------------------------------
City | BUFORD
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30519-4004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-474-1059
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ELIZABETH NOSIER-TURENNE
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 516-474-1059
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------