Provider Demographics
NPI:1598231458
Name:GILES, NATASHA (PMHNP)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:GILES
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 ATHENS HWY STE 1800
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-8293
Mailing Address - Country:US
Mailing Address - Phone:770-554-2999
Mailing Address - Fax:770-679-6390
Practice Address - Street 1:367 ATHENS HWY STE 1800
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-8293
Practice Address - Country:US
Practice Address - Phone:770-554-2999
Practice Address - Fax:770-679-6390
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN195047363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health