MEDICARE: ASHLEY NICOLE SEGNOU NP-C

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	363LF0000X	Family Nurse Practitioner	RN204968	GA

General Provider Information

NPI Number	:	1104646314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY NICOLE SEGNOU NP-C

Provider Business Mailing Address
First Line	:	2738 N DECATUR RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-5910
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2738 N DECATUR RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-5910
Country	:	US
Telephone Number	:	866-389-2727
Fax Number	:

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

Provider Enumeration Date	:	10/12/2024
Last Update Date	:	03/16/2026

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