Provider Demographics
NPI:1295420289
Name:FOSTERING RESILIENCE LLC
Entity type:Organization
Organization Name:FOSTERING RESILIENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKERA
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:SNELLING
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C/PMHNP-BC
Authorized Official - Phone:205-475-6868
Mailing Address - Street 1:4850 GOLDEN PKWY STE B443
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-5842
Mailing Address - Country:US
Mailing Address - Phone:205-475-6868
Mailing Address - Fax:
Practice Address - Street 1:3617 BRASELTON HWY STE 104
Practice Address - Street 2:
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-4667
Practice Address - Country:US
Practice Address - Phone:205-475-6868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-06
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty