MEDICARE: CHOYCE STEVENS COE CPNP

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	208000000X	Pediatrics Physician	RN245083	GA
2	363LP0200X	Pediatric Nurse Practitioner	APRN11026551	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932856606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHOYCE STEVENS COE CPNP

Provider Business Mailing Address
First Line	:	3885 PRINCETON LAKES WAY SW STE 302
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-5590
Country	:	US
Telephone Number	:	404-629-1880
Fax Number	:	404-629-1923

Provider Business Practice Location Address
First Line	:	3885 PRINCETON LAKES WAY SW STE 302
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-5590
Country	:	US
Telephone Number	:	404-629-1880
Fax Number	:	404-629-1923

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

Provider Enumeration Date	:	03/03/2022
Last Update Date	:	01/10/2025

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