Provider Demographics
NPI:1902183726
Name:EZRATTY, DANIELA SARA (NP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELA
Middle Name:SARA
Last Name:EZRATTY
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 1:1030 N HIGHLAND AVE NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3551
Mailing Address - Country:US
Mailing Address - Phone:404-695-0103
Mailing Address - Fax:678-348-7585
Practice Address - Street 1:1030 N HIGHLAND AVE NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3551
Practice Address - Country:US
Practice Address - Phone:404-695-0103
Practice Address - Fax:678-348-7585
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN159518363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care