MEDICARE: MARK ANDREW ATKINSON

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	363LG0600X	Gerontology Nurse Practitioner	71014034A	IN
2	163W00000X	Registered Nurse	28258550A	IN

General Provider Information

NPI Number	:	1902594070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ANDREW ATKINSON

Provider Business Mailing Address
First Line	:	PO BOX 749495
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-9495
Country	:	US
Telephone Number	:	855-963-2100
Fax Number	:	813-321-1296

Provider Business Practice Location Address
First Line	:	395 WESTFIELD RD
Second Line	:
City	:	NOBLESVILLE
State	:	IN
Zip	:	46060-1425
Country	:	US
Telephone Number	:	317-770-1184
Fax Number	:	317-770-1189

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

Provider Enumeration Date	:	04/26/2023
Last Update Date	:	01/28/2026

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