Provider Demographics
NPI:1518410984
Name:BAXTER, BRIE BATCHELOR (PNP)
Entity Type:Individual
Prefix:
First Name:BRIE
Middle Name:BATCHELOR
Last Name:BAXTER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:BRIE
Other - Middle Name:ASTON
Other - Last Name:BATCHELOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5461 MERIDIAN MARKS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-785-5244
Mailing Address - Fax:
Practice Address - Street 1:5461 MERIDIAN MARKS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-785-5244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN177269363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics