Provider Demographics
NPI:1770973141
Name:SHEALY, NANETTE
Entity type:Individual
Prefix:MS
First Name:NANETTE
Middle Name:
Last Name:SHEALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 RIVERWOOD PKWY SE
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6401
Mailing Address - Country:US
Mailing Address - Phone:404-889-2300
Mailing Address - Fax:
Practice Address - Street 1:3350 RIVERWOOD PKWY SE
Practice Address - Street 2:SUITE 1900
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6401
Practice Address - Country:US
Practice Address - Phone:404-889-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN128309163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse