Provider Demographics
NPI:1780014381
Name:FALCONER, DWANNA VERCHELLE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:DWANNA
Middle Name:VERCHELLE
Last Name:FALCONER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:531 ROSELANE ST NW STE 710
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6975
Mailing Address - Country:US
Mailing Address - Phone:678-331-3297
Mailing Address - Fax:678-581-7187
Practice Address - Street 1:6002 PROFESSIONAL PKWY STE 220
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5627
Practice Address - Country:US
Practice Address - Phone:678-715-9690
Practice Address - Fax:678-581-7140
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN091867363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GANPIOther1780014381