Provider Demographics
NPI:1316370745
Name:WOMEN'S HEALTHCARE NETWORK
Entity Type:Organization
Organization Name:WOMEN'S HEALTHCARE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SURAYYAH
Authorized Official - Middle Name:WAJEEDAH
Authorized Official - Last Name:FAREED
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:404-243-4433
Mailing Address - Street 1:2855 CANDLER RD STE 14
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-1415
Mailing Address - Country:US
Mailing Address - Phone:404-243-4433
Mailing Address - Fax:
Practice Address - Street 1:2855 CANDLER RD STE 14
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-1415
Practice Address - Country:US
Practice Address - Phone:404-243-4433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN092866367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty