Provider Demographics
NPI:1225632094
Name:NGUEDIA, NATHALIE CAREME (RPH)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:CAREME
Last Name:NGUEDIA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3799 PLEASANT OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7609
Mailing Address - Country:US
Mailing Address - Phone:678-760-9188
Mailing Address - Fax:
Practice Address - Street 1:4358 BURNS RD NW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3596
Practice Address - Country:US
Practice Address - Phone:770-564-8023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0309221835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care