Doctor Name: | GOPIKA NAIDU |
NPI Number: | 1003226069 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | RN214578 |
Business Practice Address: | 155 Lee Byrd Road Loganville, GA - 30052 |
Business Phone Number: | 7704665902 |
Business Fax Number: | |
Mailing Address: | 155 Lee Byrd Rd, Bldg 1, Suite 130 LOGANVILLE |
State: | GA |
Postal Code: | 300522310 |
Phone Number: | 7704665902 |
Fax Number: | |
NPI Enumeration Date: | 04/30/2014 |
NPI Last Update Date: | 07/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN214578 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |