Provider Demographics
NPI:1699447904
Name:ATLANTA NEUROPATHY CLINIC
Entity type:Organization
Organization Name:ATLANTA NEUROPATHY CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER-TSO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:678-218-8115
Mailing Address - Street 1:2845 TOWNLEY CIR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-4825
Mailing Address - Country:US
Mailing Address - Phone:678-218-8115
Mailing Address - Fax:
Practice Address - Street 1:1872 INDEPENDENCE SQ STE A
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-5170
Practice Address - Country:US
Practice Address - Phone:678-218-8115
Practice Address - Fax:877-247-9857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2024-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty