Provider Demographics
NPI:1811437718
Name:ZISCHKE, LATEEFAH RICHELLE (CNM)
Entity type:Individual
Prefix:MRS
First Name:LATEEFAH
Middle Name:RICHELLE
Last Name:ZISCHKE
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:LATEEFAH
Other - Middle Name:
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1513
Mailing Address - Country:US
Mailing Address - Phone:404-303-8035
Mailing Address - Fax:
Practice Address - Street 1:3905 BROOKSIDE PKWY STE 201
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-4425
Practice Address - Country:US
Practice Address - Phone:770-521-2295
Practice Address - Fax:770-255-0333
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN294401367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife