Provider Demographics
NPI:1568998177
Name:GARCIA, ROSA (FNP)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 HOSPITAL PKWY
Mailing Address - Street 2:STE 375
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-2461
Mailing Address - Country:US
Mailing Address - Phone:770-995-3300
Mailing Address - Fax:770-995-3307
Practice Address - Street 1:475 PHILIP BLVD
Practice Address - Street 2:STE 100
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-8737
Practice Address - Country:US
Practice Address - Phone:770-995-3300
Practice Address - Fax:770-995-3307
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN213225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN213225OtherNURSE LICENSE