Provider Demographics
NPI:1265237325
Name:ESPINOSA, LUIS (RN)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:ESPINOSA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 MARTIN MILL RD
Mailing Address - Street 2:
Mailing Address - City:MORELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30259-2526
Mailing Address - Country:US
Mailing Address - Phone:305-988-0135
Mailing Address - Fax:
Practice Address - Street 1:5555 GLENRIDGE CONNECTOR STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4815
Practice Address - Country:US
Practice Address - Phone:305-988-0135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN287170163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health