Provider Demographics
NPI:1659030427
Name:DESTINY HEALTH ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DESTINY HEALTH ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:MERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:OYERINDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-574-6589
Mailing Address - Street 1:4742 LANTERN CT. LITHONIA GA 30038
Mailing Address - Street 2:4742 LANTERN COURT
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038
Mailing Address - Country:US
Mailing Address - Phone:470-574-6589
Mailing Address - Fax:
Practice Address - Street 1:4742 LANTERN CT. LITHONIA GA 30038
Practice Address - Street 2:4742 LANTERN COURT
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038
Practice Address - Country:US
Practice Address - Phone:470-574-6589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty