Provider Demographics
NPI:1689270282
Name:PRICE, LINDA DENECIA (DNP, CPNP-PC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:DENECIA
Last Name:PRICE
Suffix:
Gender:F
Credentials:DNP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 CENTENNIAL COMMONS BND NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-2173
Mailing Address - Country:US
Mailing Address - Phone:404-539-6621
Mailing Address - Fax:
Practice Address - Street 1:1040 BOULEVARD SE STE M
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-3812
Practice Address - Country:US
Practice Address - Phone:404-539-6621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN154069363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics