MEDICARE: MARCIA BARBARA MCINTOSH NP

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	RN189290	GA

General Provider Information

NPI Number	:	1295125268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCIA BARBARA MCINTOSH NP

Provider Business Mailing Address
First Line	:	2800 SPRINGDALE RD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-7802
Country	:	US
Telephone Number	:	404-616-8100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 SPRINGDALE RD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30315-7802
Country	:	US
Telephone Number	:	404-616-8100
Fax Number	:

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

Provider Enumeration Date	:	01/29/2015
Last Update Date	:	05/11/2022

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