CRYSTALINE JOI PROTHRO (NPI# 1568060846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568060846 |
| Entity Type | Individual |
| Full Name | CRYSTALINE JOI PROTHRO |
| Practice Address |
4085 Springvale Way Mcdonough GA 30252-6872 |
| Practice Telephone | 7709129830 |
| Mailing Telephone | 7709129830 |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN233492 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4085 SPRINGVALE WAY |
| City | MCDONOUGH |
| State | GA |
| Zip Code | 30252-6872 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073114427 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 3479 Highway 81 East, Mcdonough, GA 30252 | 2020-11-03 |
| 1770143547 | Kevin Kirk Anderson | Physical Therapist | Dr. Kevin Anderson, 196 Lake Dow Rd, Mcdonough, GA 30252 | 2019-06-14 |
| 1912474537 | Atlanta Neuromonitoring, LLC | Psychiatry & Neurology | 922 Highway 81 East # 242, Mcdonough, GA 30252 | 2018-11-01 |
| 1194271320 | Christine Williams Breeden | Registered Nurse | 189 Irwin Drive, Mcdonough, GA 30252 | 2016-08-28 |
| 1518322395 | Jaquita Shorts | Counselor | 1705 Pennslyvania Ave, Mcdonough, GA 30252 | 2015-12-22 |
| 1356758973 | Keisha Candies | Counselor | 125 Zack Hinton Pkwy, Mcdonough, GA 30252 | 2014-07-15 |
| 1093145666 | Ceisha Shador Parks | Counselor | 6040 Winston Trace, Mcdonough, GA 30252 | 2013-11-19 |
| 1588939565 | Tasha E Jones | Counselor | 1509 Bent River Cir, Mcdonough, GA 30252 | 2012-03-09 |
| 1598049447 | Proactive Rehab, Inc | Physical Therapist | 50 Lawrenceville Street, Suite 100, Mcdonough, GA 30252 | 2011-10-10 |
| 1164706131 | Michelle Lee Cone | Pharmacist | 1210 Bent Creek Dr, Mcdonough, GA 30252 | 2011-10-07 |
| Find all providers in zip 30252 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578986 | Marjorie Sewannyana | Nurse Practitioner | 553 Camano Way, Mcdonough, GA 30253-8377 | 2020-11-03 |
| 1790393064 | Nicole L Smith | Nurse Practitioner | 505 Bingham Dr, Mcdonough, GA 30253-8050 | 2020-07-22 |
| 1528676046 | Joseph Ndangoh Fongod | Nurse Practitioner | 1289 Heartwood Ave, Mcdonough, GA 30253-3070 | 2020-07-21 |
| 1881211233 | Adelaida L. Mayeta Peart | Nurse Practitioner | 208 Shelton Dr, Mcdonough, GA 30252-3124 | 2020-07-01 |
| 1619593886 | Heather E Cameron | Nurse Practitioner | 50 Kelly Rd Ste 200, Mcdonough, GA 30253-6097 | 2020-06-23 |
| 1023631157 | Catherine A Nkongho | Nurse Practitioner | 437 Concord Cir, Mcdonough, GA 30253-8001 | 2020-05-23 |
| 1336774876 | Alvin O Mcdonald | Nurse Practitioner | 312 Horsehill St, Mcdonough, GA 30253-4666 | 2020-03-05 |
| 1376178798 | Hannah Lynn Mccall | Nurse Practitioner | 437 Stallsworth Rd, Mcdonough, GA 30252-6140 | 2020-03-05 |
| 1376177295 | Sandy Zachery | Nurse Practitioner | 526 Bentley Way, Mcdonough, GA 30253-3762 | 2020-02-29 |
| 1528691490 | Marion Bruno-gaston | Nurse Practitioner | 272 Mckinley Loop, Mcdonough, GA 30253-8728 | 2020-02-19 |
| Find all providers in MCDONOUGH | ||||
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| 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.