Ennis, Nadine Angela
Ennis, Nadine Angela is an individual health care provider with primary practice located at 3620 Martin Luther King Jr Dr Sw , Atlanta GA 30331-3711. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Ennis, Nadine Angela can be contacted via phone (404) 696-7300.Contact Information
Primary practice address
3620 Martin Luther King Jr Dr Sw
Atlanta GA 30331-3711
Phone: (404) 696-7300
Fax: (404) 699-3514
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 004493 | Georgia |
Profile Details
| NPI number | 1962571612 |
|---|---|
| LBN Legal business name | Ennis, Nadine Angela |
| Credentials | P.A.C. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Sep 27th, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962571612 | NPPES |
| Georgia | MEDICAID | 457877647A | |
| Georgia | MEDICAID | 457877647C | |
| Georgia | MEDICAID | 457877647D | |
| Georgia | MEDICAID | 457877647B | |
| Georgia | MEDICAID | 457877647E |
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