Provider Demographics
NPI:1518307594
Name:MAKAREWICZ, ANTOINETTE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:MAKAREWICZ
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CLAIREMONT AVE
Mailing Address - Street 2:SUITE 380
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2558
Mailing Address - Country:US
Mailing Address - Phone:404-288-0186
Mailing Address - Fax:404-228-3160
Practice Address - Street 1:125 CLAIREMONT AVE
Practice Address - Street 2:SUITE 380
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2558
Practice Address - Country:US
Practice Address - Phone:404-288-0186
Practice Address - Fax:404-228-3160
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-05
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN123717163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health