Provider Demographics
NPI:1932444650
Name:EARNEST, NINA CHOI (C-PNP, RN)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:CHOI
Last Name:EARNEST
Suffix:
Gender:F
Credentials:C-PNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 FIVE FORKS TRICKUM RD SW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-3130
Mailing Address - Country:US
Mailing Address - Phone:770-923-6400
Mailing Address - Fax:770-564-1697
Practice Address - Street 1:4140 FIVE FORKS TRICKUM RD SW
Practice Address - Street 2:SUITE 102
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-3130
Practice Address - Country:US
Practice Address - Phone:770-923-6400
Practice Address - Fax:770-564-1697
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN217816363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics