Provider Demographics
NPI:1609488147
Name:ISAGBA, JOSEPH UZEZI (FNP-C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:UZEZI
Last Name:ISAGBA
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 BUFORD HWY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3673
Mailing Address - Country:US
Mailing Address - Phone:866-386-2727
Mailing Address - Fax:
Practice Address - Street 1:5370 LAUREL SPRINGS PKWY
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6027
Practice Address - Country:US
Practice Address - Phone:678-947-6614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA245498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily