MEDICARE: PEACE NNEKA AGUZIE

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	GAA-NP004168	GA

General Provider Information

NPI Number	:	1992669402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEACE NNEKA AGUZIE

Provider Business Mailing Address
First Line	:	2763 NORTHWOOD COURT SW
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2763 NORTHWOOD COURT SW
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060
Country	:	US
Telephone Number	:	443-620-3067
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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