MEDICARE: VIVIAN CHIOMA AKABUEZE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN217151	GA

General Provider Information

NPI Number	:	1073866463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVIAN CHIOMA AKABUEZE RN

Provider Business Mailing Address
First Line	:	1837 PIERCE WAY
Second Line	:
City	:	BUFORD
State	:	GA
Zip	:	30519-2250
Country	:	US
Telephone Number	:	678-462-5336
Fax Number	:	678-833-0824

Provider Business Practice Location Address
First Line	:	2700 BRASELTON HWY STE 10-412
Second Line	:
City	:	DACULA
State	:	GA
Zip	:	30019-3262
Country	:	US
Telephone Number	:	678-243-0550
Fax Number	:	678-833-0824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2012
Last Update Date	:	03/11/2026

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