CARMEN NICOLLE SEZONOV (NPI# 1508491390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508491390 |
| Entity Type | Individual |
| Full Name | CARMEN NICOLLE SEZONOV |
| Practice Address |
910 Athens Hwy Loganville GA 30052-4952 |
| Practice Telephone | 7705541111 |
| Practice Fax Number | 7705548717 |
| Mailing Telephone | 7705541111 |
| Mailing Fax Number | 7705548717 |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
018478 | GA | Pharmacy Service Providers |
| Street Address |
910 ATHENS HWY |
| City | LOGANVILLE |
| State | GA |
| Zip Code | 30052-4952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386678126 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 910 Athens Hwy, Loganville, GA 30052-4952 | 2006-07-10 |
| 1851999312 | Deborah M Roberts | Pharmacist | 910 Athens Hwy, Loganville, GA 30052-4952 | 2020-10-15 |
| 1376878074 | Persis Bristol | Doula | 910 Athens Hwy, Suite K#124, Loganville, GA 30052-4952 | 2009-10-14 |
| 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 | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215326707 | Gayle M Tanenbaum | Pharmacist | 1401 Bulloch Lake Ct, Loganville, GA 30052-8649 | 2015-01-21 |
| 1851999312 | Deborah M Roberts | Pharmacist | 910 Athens Hwy, Loganville, GA 30052-4952 | 2020-10-15 |
| 1225647258 | Jeffrey Slade Johnson | Pharmacist | 4753 Atlanta Hwy, Loganville, GA 30052-7307 | 2020-07-27 |
| 1194333435 | Christy Darlene Cherry | Pharmacist | 4753 Atlanta Hwy, Loganville, GA 30052-7307 | 2020-07-22 |
| 1881202216 | Lisa Marie Slaughter | Pharmacist | 4753 Atlanta Hwy, Loganville, GA 30052-7307 | 2020-07-22 |
| 1043832074 | Monica Mccullers Walker | Pharmacist | 4753 Atlanta Hwy, Loganville, GA 30052-7307 | 2020-05-13 |
| 1649802406 | Deedee Miller | Pharmacist | 4753 Atlanta Hwy, Loganville, GA 30052-7307 | 2020-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306445747 | Hiep Hoang Do | Pharmacist | 801 Burns Estates Dr, Lilburn, GA 30047-3484 | 2020-10-17 |
| 1518565902 | Edward Edeh | Pharmacist | 1232 South Hairstoh Road, Stone Mountain, GA 30088 | 2020-10-16 |
| 1548868342 | Jackson Gathuru Ngugi | Pharmacist | 193 Anniversary Ln, Acworth, GA 30102-2045 | 2020-10-14 |
| 1568086494 | Lynn Berner Marshall | Pharmacist | 3823 Club Forest Dr, Peachtree Corners, GA 30092-2369 | 2020-06-06 |
| 1295357325 | Rhonda Ireland | Pharmacist | 125 Main Street Marketplace, Cartersville, GA 30120 | 2020-05-12 |
| 1073132676 | Khushboo S Rhodes | Pharmacist | 3101 Roswell Rd Ste 132, Marietta, GA 30062-5523 | 2020-04-14 |
| 1194354647 | Deanna W Mcewen | Pharmacist | 1720 Epps Bridge Road, Athens, GA 30606-6132 | 2020-04-06 |
| 1104452663 | Latrena Solomon | Pharmacist | 1750 Highway 138 E, Stockbridge, GA 30281-2810 | 2020-03-17 |
| 1497389597 | Rx Healthcare Ltd | Pharmacist | 2136 W Park Ct Ste I, Stone Mountain, GA 30087-3528 | 2020-02-27 |
| 1972136273 | Shannon Sulik | Pharmacist | 774 Highway 96, Bonaire, GA 31005-3300 | 2020-02-15 |
| Find all providers with the same taxonomy | ||||
| City | LOGANVILLE |
| Zip Code | 30052 |
Please comment or provide details below to improve the information on CARMEN NICOLLE SEZONOV.
| 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.