Provider Demographics
NPI:1386982460
Name:DDP NURSING SERVICES OF GA. INC
Entity type:Organization
Organization Name:DDP NURSING SERVICES OF GA. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL-BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-760-1597
Mailing Address - Street 1:2552 WESTCHESTER WAY SE # SS
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-6448
Mailing Address - Country:US
Mailing Address - Phone:770-760-1597
Mailing Address - Fax:
Practice Address - Street 1:2552 WESTCHESTER WAY SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-6448
Practice Address - Country:US
Practice Address - Phone:770-760-1597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty