Provider Demographics
NPI:1831736826
Name:BORCHERS, CAROL LORRAINE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:LORRAINE
Last Name:BORCHERS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:LORRAINE
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3648 PEACHTREE RD NE APT 1J
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1271
Mailing Address - Country:US
Mailing Address - Phone:678-508-2612
Mailing Address - Fax:
Practice Address - Street 1:3648 PEACHTREE RD NE APT 1J
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-1271
Practice Address - Country:US
Practice Address - Phone:678-508-2612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA252410363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty