Provider Demographics
NPI:1568965028
Name:NACHTMAN, CARA (AGACNP)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:NACHTMAN
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:NACHTMAN
Other - Last Name:GIFFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AGACNP
Mailing Address - Street 1:841 FREDERICA ST NE APT 25
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE BLDG 3245A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308
Practice Address - Country:US
Practice Address - Phone:404-778-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN227857363LA2100X, 163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine