Provider Demographics
NPI:1003668971
Name:GEORGES, SOPHIA P (AGNP-C)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:P
Last Name:GEORGES
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1039 HIGHLAND LAKE CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3457
Mailing Address - Country:US
Mailing Address - Phone:513-348-2926
Mailing Address - Fax:
Practice Address - Street 1:1039 HIGHLAND LAKE CIR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3457
Practice Address - Country:US
Practice Address - Phone:513-348-2926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN315199363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner