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NPI Code Detail

MEDICARE: NISHA JIWANI ALI APRN

MEDICARE: NISHA JIWANI ALI APRN
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
1363LF0000XFamily Nurse PractitionerRN194032GA

General Provider Information

NPI Number : 1861711749
Entity Type Code : Individual
Provider Name (Legal Business Name) : NISHA JIWANI ALI APRN
Provider Business Mailing Address
First Line : 2994 ATLANTA RD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-3655
Country : US
Telephone Number : 404-786-7275
Fax Number :
Provider Business Practice Location Address
First Line : 2994 ATLANTA RD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-3655
Country : US
Telephone Number : 404-786-7275
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2010
Last Update Date : 04/11/2018

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