Provider Demographics
NPI:1093195034
Name:NARCOLEPSIA, LLC
Entity Type:Organization
Organization Name:NARCOLEPSIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:LEANNE
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:770-862-1951
Mailing Address - Street 1:6455 BROOKLINE CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-7041
Mailing Address - Country:US
Mailing Address - Phone:770-862-1951
Mailing Address - Fax:
Practice Address - Street 1:6455 BROOKLINE CT
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-7041
Practice Address - Country:US
Practice Address - Phone:770-862-1951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA154529367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty