MEDICARE: GILA HERMAN 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN-NP215947	GA
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN215947	GA

General Provider Information

NPI Number	:	1578036653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GILA HERMAN NP

Provider Business Mailing Address
First Line	:	6100 LAKE FORREST DR STE 450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-3837
Country	:	US
Telephone Number	:	205-671-4338
Fax Number	:	404-549-9316

Provider Business Practice Location Address
First Line	:	6100 LAKE FORREST DR STE 450
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-3837
Country	:	US
Telephone Number	:	205-671-4338
Fax Number	:

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

Provider Enumeration Date	:	01/10/2019
Last Update Date	:	12/04/2025

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