| Community Holistic Advanced Practice Nurses (chapn) Llc | |
|
1707 N. Blairs Bridge Road Austell GA 30168-5537 | |
| (404) 793-3806 | |
| (770) 502-6492 |
| Full Name | Community Holistic Advanced Practice Nurses (chapn) Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1707 N. Blairs Bridge Road, Austell, Georgia |
| Authorized Official Name and Position | Natalie Mccall-gaston (CEO) |
| Authorized Official Contact | 6786414391 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Holistic Advanced Practice Nurses (chapn) Llc 1707 North Blairs Bridge Rd Austell GA 30168-4659 Ph: (404) 793-3806 | Community Holistic Advanced Practice Nurses (chapn) Llc 1707 N. Blairs Bridge Road Austell GA 30168-5537 Ph: (404) 793-3806 |
| NPI Number | 1992253322 |
|---|---|
| Provider Enumeration Date | 09/14/2016 |
| Last Update Date | 03/10/2021 |
| Medicare PECOS PAC ID | 9830476795 |
|---|---|
| Medicare Enrollment ID | O20170501002536 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992253322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marilyn Elaine Whitening |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730448564 PECOS PAC ID: 2365607868 Enrollment ID: I20120709000306 |
| Provider Name | Natalie Y Mccall-gaston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639515455 PECOS PAC ID: 4587806542 Enrollment ID: I20130805000419 |
| Provider Name | Lavona C Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245677806 PECOS PAC ID: 4385878222 Enrollment ID: I20131009001099 |
| Provider Name | Jay Frederick Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447699152 PECOS PAC ID: 8527380294 Enrollment ID: I20180831002324 |
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