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General NPI Number Information
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NPI Number | 1952047482
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Entity Type | Individual
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Provider Name | CADIE ELIZABETH WALSH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/08/2022
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 3167 PEACHTREE RD NE STE G
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City | ATLANTA
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State | GA
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Zip | 30305-1812
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Country | US
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Telephone | 770-504-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 345 GUNSTON HALL CIR
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City | MILTON
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State | GA
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Zip | 30004-7506
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Country | US
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Telephone | 770-871-5773
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | RN311022
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License Number State | GA
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