Provider Demographics
NPI:1609314376
Name:PATEL, SAJANI PARESH (NP-C)
Entity Type:Individual
Prefix:
First Name:SAJANI
Middle Name:PARESH
Last Name:PATEL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 JIMMY CARTER BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3760
Mailing Address - Country:US
Mailing Address - Phone:470-275-4911
Mailing Address - Fax:
Practice Address - Street 1:4775 JIMMY CARTER BLVD STE 201
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3760
Practice Address - Country:US
Practice Address - Phone:470-275-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF01170949364SF0001X
GARN220515363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF01170949OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS