Provider Demographics
NPI:1689259517
Name:MOCANU, IRINA (NP)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:MOCANU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3963 DEVON OAKS DR NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-2127
Mailing Address - Country:US
Mailing Address - Phone:770-880-2250
Mailing Address - Fax:
Practice Address - Street 1:3963 DEVON OAKS DR NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-2127
Practice Address - Country:US
Practice Address - Phone:770-880-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-11
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN246912363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily