MEDICARE: BELINDA I OPARA NURSE PRACTITIONER

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	RN171917	GA

General Provider Information

NPI Number	:	1114437704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BELINDA I OPARA NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	871 FOXCROFT TRL SE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-5757
Country	:	US
Telephone Number	:	404-454-3150
Fax Number	:

Provider Business Practice Location Address
First Line	:	483 INDIAN TRAIL LILBURN RD NW
Second Line	:
City	:	LILBURN
State	:	GA
Zip	:	30047-3717
Country	:	US
Telephone Number	:	770-923-4433
Fax Number	:

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

Provider Enumeration Date	:	10/09/2017
Last Update Date	:	03/30/2021

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