Provider Demographics
NPI:1063228005
Name:DANDY, TEMEKA (FNP-C)
Entity type:Individual
Prefix:
First Name:TEMEKA
Middle Name:
Last Name:DANDY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5235 MILLER WOODS TRL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3711
Mailing Address - Country:US
Mailing Address - Phone:205-586-1303
Mailing Address - Fax:678-518-8741
Practice Address - Street 1:5235 MILLER WOODS TRL
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3711
Practice Address - Country:US
Practice Address - Phone:205-586-1303
Practice Address - Fax:678-518-8741
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN210851207Q00000X, 207R00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse