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General NPI Number Information
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NPI Number | 1972926152
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Entity Type | Individual
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Provider Name | ROVI-JANE MEHTA NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 03/21/2016
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Provider Practice Location Address
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Address Line | 758 OLD NORCROSS RD SUITE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3385
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Country | US
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Telephone | 770-962-4300
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Fax | 770-339-7544
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Provider Business Mailing Address
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Address Line | 758 OLD NORCROSS RD SUITE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3385
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Country | US
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Telephone | 770-962-4300
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Fax | 770-339-7544
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN157541
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License Number State | GA
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