Provider Demographics
NPI:1316148711
Name:HELLAM, PATRICIA LYNN (NP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN
Last Name:HELLAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LYNN
Other - Last Name:STAUFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4181 HOSPITAL DR NE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2541
Mailing Address - Country:US
Mailing Address - Phone:770-787-7444
Mailing Address - Fax:770-787-5050
Practice Address - Street 1:4181 HOSPITAL DR NE
Practice Address - Street 2:SUITE 202
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2541
Practice Address - Country:US
Practice Address - Phone:770-787-7444
Practice Address - Fax:770-787-5050
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN132478NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA919995801CMedicaid