Provider Demographics
NPI:1043676380
Name:NOZILE, PETRA (FNP-C)
Entity Type:Individual
Prefix:
First Name:PETRA
Middle Name:
Last Name:NOZILE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:PETRA
Other - Middle Name:
Other - Last Name:NOZILE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:3333 RIVERWOOD PKWY SE STE 250
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3304
Mailing Address - Country:US
Mailing Address - Phone:770-914-0116
Mailing Address - Fax:
Practice Address - Street 1:1058 BEAR CREEK BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:GA
Practice Address - Zip Code:30228-1849
Practice Address - Country:US
Practice Address - Phone:770-707-0808
Practice Address - Fax:770-707-1580
Is Sole Proprietor?:No
Enumeration Date:2015-12-31
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN174065363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily