Provider Demographics
NPI:1801431333
Name:DUFFEY, NATHAN GARRETT (AGACNP-BC)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:GARRETT
Last Name:DUFFEY
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 JEWEL DR
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-5120
Mailing Address - Country:US
Mailing Address - Phone:404-516-2267
Mailing Address - Fax:
Practice Address - Street 1:775 POPLAR RD STE 160
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-8302
Practice Address - Country:US
Practice Address - Phone:770-400-4630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN227595363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care