Provider Demographics
NPI:1801081286
Name:AINA, JOAN O (DNP,FNP, PMHNP, CWS)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:O
Last Name:AINA
Suffix:
Gender:F
Credentials:DNP,FNP, PMHNP, CWS
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:OMOWUMI
Other - Last Name:AINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:320 LANIER AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-7443
Mailing Address - Country:US
Mailing Address - Phone:404-707-6462
Mailing Address - Fax:770-461-3696
Practice Address - Street 1:320 LANIER AVE W STE 200
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-7443
Practice Address - Country:US
Practice Address - Phone:404-707-6462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN153656163WW0000X, 163WX1500X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No163WX1500XNursing Service ProvidersRegistered NurseOstomy CareGroup - Multi-Specialty