Provider Demographics
NPI:1992583041
Name:LOLANDES FERNANDEZ, DANIELA P (FNP-C)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:P
Last Name:LOLANDES FERNANDEZ
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 1:1429 LIBERTY PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-9390
Mailing Address - Country:US
Mailing Address - Phone:678-525-2884
Mailing Address - Fax:
Practice Address - Street 1:4961 BUFORD HWY STE 201
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-3536
Practice Address - Country:US
Practice Address - Phone:770-733-1077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN280946363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily