Provider Demographics
NPI:1093493538
Name:VENN, NYAH SAPPIA (CSA)
Entity Type:Individual
Prefix:
First Name:NYAH
Middle Name:SAPPIA
Last Name:VENN
Suffix:
Gender:M
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 420827
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-0827
Mailing Address - Country:US
Mailing Address - Phone:404-303-7703
Mailing Address - Fax:404-303-7706
Practice Address - Street 1:5881 GLENRIDGE DR STE 120
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-8184
Practice Address - Country:US
Practice Address - Phone:404-303-7703
Practice Address - Fax:404-303-7706
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA23-461363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical