CHARLES GUILLAUME (NPI# 1114322419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114322419 |
| Entity Type | Individual |
| Full Name | CHARLES GUILLAUME |
| Practice Address |
500 Plantation Park Dr Loganville GA 30052-4144 |
| Mailing Address |
1637 Athens Hwy Grayson GA 30017-1768 |
| Practice Telephone | 6783448268 |
| Practice Fax Number | 8886276444 |
| Mailing Telephone | 6782540917 |
| Mailing Fax Number | 8886276444 |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2020-01-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
180218 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
180218 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
500 PLANTATION PARK DR |
| City | LOGANVILLE |
| State | GA |
| Zip Code | 30052-4144 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043302037 | Muhammad Shakeel Ahmed | Psychiatry & Neurology | 500 Plantation Park Dr, Loganville, GA 30052 | 2006-09-28 |
| 1164063814 | Chantae Aletha Bryant | Nurse Practitioner | 500 Plantation Park Dr, Loganville, GA 30052-4144 | 2019-10-03 |
| 1104149160 | Life Healing Center PC | Psychiatry & Neurology | 500 Plantation Park Dr, Loganville, GA 30052-4144 | 2010-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482397 | A Better Life Together, Inc | Day Training, Developmentally Disabled Services | 3343 Woodshade Drive, Loganville, GA 30052 | 2020-09-18 |
| 1184285025 | Felicia Maria Anderson | Counselor | 272 Fox Run, Loganville, GA 30052 | 2019-06-21 |
| 1225502768 | Jackie Kabahuma Zziwa | Registered Nurse | 4072 Atlanta High Way, Loganville, GA 30052 | 2019-01-17 |
| 1598243024 | Afolasade A Adeyemo | In Home Supportive Care | 154 Towler Shoals Dr, Loganville, GA 30052 | 2018-08-06 |
| 1831688654 | Julia Smith | Physician Assistant | 2745 Loganville Hwy, Loganville, GA 30052 | 2018-05-07 |
| 1306335534 | Emily Jannine Jamshedi | Physician Assistant | 3461 Skyland Ridge Ct, Loganville, GA 30052 | 2018-05-03 |
| 1346738655 | Laura Martha Avila | Nurse Practitioner | 221 The Esplanade Way Se, Loganville, GA 30052 | 2018-04-23 |
| 1942738901 | Local Dental Partners, LLC | Clinic/Center | 4353 Atlanta Highway Suite. 300, Loganville, GA 30052 | 2017-06-02 |
| 1649702804 | Cynthia Reeves | Counselor | 4160 Logan Drive, Loganville, GA 30052 | 2017-03-28 |
| 1689049330 | Samuel S Kwon - Loganville Dmd PC | Dentist | 2101 Baker Carter Drive, Suite 200, Loganville, GA 30052 | 2015-12-07 |
| Find all providers in zip 30052 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558750752 | Amanda Frances Lee | Nurse Practitioner | 5416 Forest Falls Dr, Loganville, GA 30052-3441 | 2015-01-12 |
| 1972786564 | Mary-theresia Kemni Wallang-nwaha | Nurse Practitioner | 1260 Rose Terrace Cir, Loganville, GA 30052-9047 | 2007-12-06 |
| 1124625231 | Roseylee Kuriakose | Nurse Practitioner | 367 Athens Hwy, Loganville, GA 30052-2204 | 2020-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154110 | Christina Danielle Palau Vaccari | Nurse Practitioner | 712 Pasley Ave Se, Atlanta, GA 30316-2158 | 2020-11-07 |
| 1427657113 | Cynthia Diane Prather | Nurse Practitioner | 3264 Lower Boston Rd, Thomasville, GA 31757-1311 | 2020-10-22 |
| 1932706728 | Alecia Ann Czarnecki | Nurse Practitioner | 6240 Crooked Creek Dr, Rex, GA 30273-5006 | 2020-10-05 |
| 1801401112 | Cotenna D. Clark | Nurse Practitioner | 1857 Cameo Ct, Tucker, GA 30084-7002 | 2020-09-14 |
| 1487264370 | Helen Young Yates | Nurse Practitioner | 40 Red Rock Ct Ne, Ludowici, GA 31316-6280 | 2020-08-05 |
| 1982214334 | Jasmine Alecia Henderson | Nurse Practitioner | 52 Roseberry Cir, Port Wentworth, GA 31407-5612 | 2020-07-31 |
| 1275142994 | Theresia Richardson | Nurse Practitioner | 2033 Buford Hwy Ste 109, Buford, GA 30518-8802 | 2020-07-28 |
| 1063021277 | Elsa Duncan Duncan | Nurse Practitioner | 1822 E Gwinnett St, Savannah, GA 31404-1853 | 2020-07-24 |
| 1154941946 | Joy P Wharton | Nurse Practitioner | 182 Silver Arrow Cir, Austell, GA 30168-7490 | 2020-04-21 |
| 1235769985 | Michelle Brack | Nurse Practitioner | 502 Hall Rd, Thomasville, GA 31757-8105 | 2020-01-22 |
| Find all providers with the same taxonomy | ||||
| City | LOGANVILLE |
| Zip Code | 30052 |
Please comment or provide details below to improve the information on CHARLES GUILLAUME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.