| Nissi Family Medicine Llc | |
|
1810 Mulkey Rd Suite 105 Austell GA 30106-1151 | |
| (678) 540-7597 | |
| (770) 645-9802 |
| Full Name | Nissi Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1810 Mulkey Rd, Austell, Georgia |
| Authorized Official Name and Position | Marga Ngwang (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 6785407597 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nissi Family Medicine Llc 1810 Mulkey Rd Suite 105 Austell GA 30106-1151 Ph: (678) 540-7597 | Nissi Family Medicine Llc 1810 Mulkey Rd Suite 105 Austell GA 30106-1151 Ph: (678) 540-7597 |
| NPI Number | 1083010201 |
|---|---|
| Provider Enumeration Date | 11/16/2014 |
| Last Update Date | 11/16/2014 |
| Medicare PECOS PAC ID | 5092032763 |
|---|---|
| Medicare Enrollment ID | O20150318001867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083010201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sylena Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740563121 PECOS PAC ID: 7214189570 Enrollment ID: I20121212000567 |
| Provider Name | Marga B Ngwang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861703654 PECOS PAC ID: 0446486583 Enrollment ID: I20131120001811 |
| Provider Name | Sonia Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932558137 PECOS PAC ID: 3971890450 Enrollment ID: I20160927002157 |
| Provider Name | Tiffany E Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821509183 PECOS PAC ID: 4587922554 Enrollment ID: I20171220002412 |
| Provider Name | Amanda Manuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942740758 PECOS PAC ID: 9032459029 Enrollment ID: I20190329001686 |
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