Provider Demographics
NPI:1942817648
Name:VIZEN, FRANK JAMES (PMHNP)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JAMES
Last Name:VIZEN
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 CASTLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5073
Mailing Address - Country:US
Mailing Address - Phone:470-266-7510
Mailing Address - Fax:
Practice Address - Street 1:2151 PEACHFORD RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6599
Practice Address - Country:US
Practice Address - Phone:770-455-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-26
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2022061663363LP0808X
GARN265029163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health