Provider Demographics
NPI:1760741904
Name:ATEN, STEPHANIE JOY (NP-C, CNM)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JOY
Last Name:ATEN
Suffix:
Gender:F
Credentials:NP-C, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:STE 520
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6146
Mailing Address - Country:US
Mailing Address - Phone:229-881-9033
Mailing Address - Fax:
Practice Address - Street 1:2665 N DECATUR RD STE 520
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6146
Practice Address - Country:US
Practice Address - Phone:404-299-2223
Practice Address - Fax:404-297-5003
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN195457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily