Provider Demographics
NPI:1275053340
Name:ATKINSON, DEVEANE TATANYA (NP)
Entity type:Individual
Prefix:MRS
First Name:DEVEANE
Middle Name:TATANYA
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:DEVEANE
Other - Middle Name:T
Other - Last Name:ATKINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:3305 COLES CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-7000
Mailing Address - Country:US
Mailing Address - Phone:678-779-6441
Mailing Address - Fax:
Practice Address - Street 1:1445 OLD MCDONOUGH HWY SE STE E
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094
Practice Address - Country:US
Practice Address - Phone:770-922-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA167706163W00000X
GARN167706363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner