Provider Demographics
NPI:1225769631
Name:ABOR, ADAORAH (NP)
Entity Type:Individual
Prefix:
First Name:ADAORAH
Middle Name:
Last Name:ABOR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5074 CENTENNIAL COMMONS DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-2167
Mailing Address - Country:US
Mailing Address - Phone:215-626-3252
Mailing Address - Fax:
Practice Address - Street 1:2131 KINGSTON CT SE # 108-110
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8929
Practice Address - Country:US
Practice Address - Phone:678-695-7137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA198435363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health