Provider Demographics
NPI:1376874958
Name:WOMEN'S HEALTH ENTERPRISE, INC
Entity Type:Organization
Organization Name:WOMEN'S HEALTH ENTERPRISE, INC
Other - Org Name:FAMILY HEALTH ENTERPRISE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:K
Authorized Official - Last Name:GALLAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:404-635-1300
Mailing Address - Street 1:634 MCDONOUGH BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-4424
Mailing Address - Country:US
Mailing Address - Phone:404-635-1300
Mailing Address - Fax:404-635-1320
Practice Address - Street 1:634 MCDONOUGH BLVD SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-4424
Practice Address - Country:US
Practice Address - Phone:404-635-1300
Practice Address - Fax:404-635-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN058116NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA85001070GMedicaid
GA85001070GMedicaid