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General NPI Number Information
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NPI Number | 1831998103
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Entity Type | Organization
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Legal Business Name | DIVINE MIND SOLUTION
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 670 PAPER CREEK DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-5329
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Country | US
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Telephone | 770-256-6542
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Fax | 770-513-9449
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Provider Business Mailing Address
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Address Line | 670 PAPER CREEK DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-5329
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Country | US
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Telephone | 770-256-6542
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Fax | 770-513-9449
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Authorized Official
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Title or Position | OWNER
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Name | BISI YINUSA
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Credential |
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Telephone | 770-256-6542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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