Provider Demographics
NPI:1295577898
Name:SPIVEY, AISHA N/A (RN)
Entity type:Individual
Prefix:MS
First Name:AISHA
Middle Name:N/A
Last Name:SPIVEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 PEGASUS WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-7652
Mailing Address - Country:US
Mailing Address - Phone:404-268-6281
Mailing Address - Fax:
Practice Address - Street 1:970 PEGASUS WAY
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-7652
Practice Address - Country:US
Practice Address - Phone:404-268-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN251083163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty