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General NPI Number Information
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NPI Number | 1790408185
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Entity Type | Individual
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Provider Name | ARIELLE JESSICA SHETTY AG-ACNP
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Gender | Female
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 1400 NORTHSIDE FORSYTH DR STE 250
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City | CUMMING
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State | GA
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Zip | 30041-7701
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Country | US
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Telephone | 770-889-7118
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Fax | 770-844-7835
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Provider Business Mailing Address
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Address Line | 2240 KILMINGTON SQ
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City | ALPHARETTA
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State | GA
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Zip | 30009-8635
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Country | US
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Telephone | 412-360-9569
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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 | 285862
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 285862
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 285862
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License Number State | GA
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