Provider Demographics
NPI:1649085945
Name:SHAH, SUCHI (RN, APRN)
Entity type:Individual
Prefix:
First Name:SUCHI
Middle Name:
Last Name:SHAH
Suffix:
Gender:
Credentials:RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 SPRING MESA DR
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-4766
Mailing Address - Country:US
Mailing Address - Phone:678-559-9132
Mailing Address - Fax:
Practice Address - Street 1:3440 SPRING MESA DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-4766
Practice Address - Country:US
Practice Address - Phone:678-559-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN324377163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse