Provider Demographics
NPI:1346703576
Name:PATEL, CHHAYA (RN)
Entity Type:Individual
Prefix:
First Name:CHHAYA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CHHAYABEN
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:2860 MAIN ST W
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-3156
Mailing Address - Country:US
Mailing Address - Phone:708-091-1007
Mailing Address - Fax:
Practice Address - Street 1:2860 MAIN ST W
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3156
Practice Address - Country:US
Practice Address - Phone:770-809-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-14
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-159543163W00000X
GARN289917363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163W00000XNursing Service ProvidersRegistered Nurse