Provider Demographics
NPI:1669993580
Name:CROSBY-MYLES, FERNANDA RENEE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:FERNANDA
Middle Name:RENEE
Last Name:CROSBY-MYLES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:310 KENNESTONE HOSPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1120
Mailing Address - Country:US
Mailing Address - Phone:770-793-7899
Mailing Address - Fax:770-793-7856
Practice Address - Street 1:310 KENNESTONE HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1120
Practice Address - Country:US
Practice Address - Phone:770-793-7899
Practice Address - Fax:770-793-7856
Is Sole Proprietor?:No
Enumeration Date:2017-06-30
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN196152364SA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care