Provider Demographics
NPI:1659478501
Name:MCBRAYER, MARCIA F (CFNP)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:F
Last Name:MCBRAYER
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1390 MONTREAL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8143
Mailing Address - Country:US
Mailing Address - Phone:404-446-4600
Mailing Address - Fax:404-446-4601
Practice Address - Street 1:1390 MONTREAL RD
Practice Address - Street 2:SUITE 180
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-8143
Practice Address - Country:US
Practice Address - Phone:404-446-4600
Practice Address - Fax:404-446-4601
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN076329363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA156727915AMedicaid