Provider Demographics
NPI:1851617039
Name:SPEIGHTS, CHARLANNA (DNP, FNP-BC, PMHNP-B)
Entity Type:Individual
Prefix:DR
First Name:CHARLANNA
Middle Name:
Last Name:SPEIGHTS
Suffix:
Gender:F
Credentials:DNP, FNP-BC, PMHNP-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GALLERIA PKWY SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5994
Mailing Address - Country:US
Mailing Address - Phone:844-206-5944
Mailing Address - Fax:
Practice Address - Street 1:600 GALLERIA PKWY SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5994
Practice Address - Country:US
Practice Address - Phone:844-206-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-14
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9281243363LF0000X, 363LP0808X
VA0024176894363LF0000X, 363LP0808X
CA95006435363LF0000X, 363LP0808X
AZAP9740363LF0000X
AL3-000011363LF0000X, 363LP0808X
TXAP137495363LF0000X, 363LP0808X
GARN243415363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001991500Medicaid