Provider Demographics
NPI:1003517947
Name:GIVENS, RITA RAYNEL (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:RAYNEL
Last Name:GIVENS
Suffix:
Gender:F
Credentials:FNP-BC
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:455 PHILIP BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-8768
Mailing Address - Country:US
Mailing Address - Phone:770-962-3642
Mailing Address - Fax:770-962-3643
Practice Address - Street 1:830 EAGLES LANDING PKWY STE 204
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7366
Practice Address - Country:US
Practice Address - Phone:770-962-3642
Practice Address - Fax:770-962-3643
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-16
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA279572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily