Provider Demographics
NPI:1245748060
Name:STRICKLAND, RENITA ROYCHELLE (ARNP)
Entity Type:Individual
Prefix:
First Name:RENITA
Middle Name:ROYCHELLE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 RIVER COVE DR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-2089
Mailing Address - Country:US
Mailing Address - Phone:904-859-9721
Mailing Address - Fax:
Practice Address - Street 1:498 CHATTIN DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8240
Practice Address - Country:US
Practice Address - Phone:678-493-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9264681363L00000X
GARN281783363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner