Provider Demographics
NPI:1487535548
Name:NELSON, DORINDA (AGPCNP)
Entity type:Individual
Prefix:MRS
First Name:DORINDA
Middle Name:
Last Name:NELSON
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 AMBER CT
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-8359
Mailing Address - Country:US
Mailing Address - Phone:678-937-8673
Mailing Address - Fax:
Practice Address - Street 1:6300 HOSPITAL PKWY STE 300
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1982
Practice Address - Country:US
Practice Address - Phone:770-623-8965
Practice Address - Fax:770-623-4018
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GANP296512363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner