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General NPI Number Information
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NPI Number | 1881217883
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Entity Type | Individual
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Provider Name | SIOBHAN ORIAIFO
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Gender | Female
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 3575 FULTON MILL ROAD
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City | MACON
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State | GA
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Zip | 31206-5117
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Country | US
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Telephone | 478-803-8434
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Fax | 478-803-8434
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Provider Business Mailing Address
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Address Line | 5588 CIRCLE STONE LANE
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City | STONE MOUNTAIN
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State | GA
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Zip | 30088-1226
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Country | US
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Telephone | 470-469-0860
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1056304
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | GAA-NP002443
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 853096
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License Number State | TX
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