Provider Demographics
NPI:1619758083
Name:PARADEE, ELIJAH COLIN (WHNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIJAH
Middle Name:COLIN
Last Name:PARADEE
Suffix:
Gender:M
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 597
Mailing Address - Street 2:
Mailing Address - City:METTER
Mailing Address - State:GA
Mailing Address - Zip Code:30439-0597
Mailing Address - Country:US
Mailing Address - Phone:912-685-1720
Mailing Address - Fax:
Practice Address - Street 1:10 DOCTORS ST
Practice Address - Street 2:
Practice Address - City:METTER
Practice Address - State:GA
Practice Address - Zip Code:30439-3337
Practice Address - Country:US
Practice Address - Phone:912-685-5715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN267907163WG0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice