Growth Mindset Wellness Pc | |
175 Corporate Center Dr Ste B Stockbridge GA 30281-7382 | |
(470) 275-2358 | |
Not Available |
Full Name | Growth Mindset Wellness Pc |
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Speciality | Nurse Practitioner |
Location | 175 Corporate Center Dr Ste B, Stockbridge, Georgia |
Authorized Official Name and Position | Tiffany Bates (OWNER) |
Authorized Official Contact | 4702752358 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Growth Mindset Wellness Pc 175 Corporate Center Dr Ste B Stockbridge GA 30281-7382 Ph: (470) 275-2358 | Growth Mindset Wellness Pc 175 Corporate Center Dr Ste B Stockbridge GA 30281-7382 Ph: (470) 275-2358 |
NPI Number | 1699408005 |
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Provider Enumeration Date | 07/04/2022 |
Last Update Date | 02/02/2024 |
Certification Date | 02/02/2024 |
Medicare PECOS PAC ID | 7315323474 |
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Medicare Enrollment ID | O20220928000242 |
Identifier | Type | State | Issuer |
---|---|---|---|
1699408005 | NPI | - | NPPES |
Provider Name | Tiffany Tamaira Bates |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457943813 PECOS PAC ID: 8224414388 Enrollment ID: I20220928000374 |
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