APRN MOBILE CLINIC LLC (NPI# 1780285486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780285486 |
| Entity Type | Organization |
| Organization Name | APRN MOBILE CLINIC LLC |
| Practice Address |
1361 Highwoods Pass Grovetown GA 30813-3994 |
| Practice Telephone | 7062671663 |
| Practice Fax Number | 7065100423 |
| Mailing Telephone | 7062671663 |
| Mailing Fax Number | 7065100423 |
| Enumeration Date | 2020-11-08 |
| Last Update Date | 2020-11-08 |
| Authorized Official Name | PASTELLE WALSTON (OWNER PROVIDER) |
| Authorized Official Telephone | 7062671663 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1361 HIGHWOODS PASS |
| City | GROVETOWN |
| State | GA |
| Zip Code | 30813-3994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598276412 | Georgia Dental Professionals, PC | Dentist | 9596 Bentley Dr., Grovetown, GA 30813 | 2017-10-18 |
| 1558891895 | Jennifer M Humm | Dentist | 250 Merridian Drive, Grovetown, GA 30813 | 2017-06-19 |
| 1710335443 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 435 Lewiston Rd, Grovetown, GA 30813 | 2016-06-03 |
| 1558727214 | Lynda R Green | Counselor | 426 Northrop Place, Grovetown, GA 30813 | 2016-01-11 |
| 1689002610 | Patriots Park Dental, LLC | Dentist | 701 Devika Drive, Ste 10, Grovetown, GA 30813 | 2013-10-30 |
| 1255680096 | David Schulte Jr. | Internal Medicine | 925 Branch Ct Ste 2101, Grovetown, GA 30813 | 2012-09-07 |
| 1548519481 | Ashley Roberts Saunders | Pharmacist | 869 Horizon South Parkway, Grovetown, GA 30813 | 2012-09-06 |
| 1447569694 | Wallace Allen Partridge Jr. | Pharmacist | 5104 Wrightsboro Rd., Fred's Pharmacy 1699, Grovetown, GA 30813 | 2010-10-05 |
| 1497908149 | Sharon M Blair | Registered Nurse | 7640 Pleasantville Way, Grovetown, GA 30813 | 2008-10-28 |
| 1710160791 | Rebecca Meek | Nurse Practitioner | 469 Lewiston Rd, Grovetown, GA 30813 | 2007-12-12 |
| Find all providers in zip 30813 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376107151 | Ashley Turman Sabb | Nurse Practitioner | 1424 Calumet Dr, Grovetown, GA 30813-3839 | 2019-04-26 |
| 1700391521 | Jennifer Sheridan Mccarthy | Nurse Practitioner | 703 Greenwich Ct, Grovetown, GA 30813-5882 | 2017-12-04 |
| 1417472556 | Desiree Mock | Nurse Practitioner | 443 Carole Dr, Grovetown, GA 30813-4106 | 2017-08-10 |
| 1558714238 | David Kelly | Nurse Practitioner | 101 Fornum Dr, Grovetown, GA 30813-2697 | 2016-07-19 |
| 1376942037 | Amber Jillian Mccall | Nurse Practitioner | 1433 Sawmill Trl, Grovetown, GA 30813-3995 | 2014-08-19 |
| 1871920520 | Denise Miller | Nurse Practitioner | 756 Reynolds Rd, Grovetown, GA 30813-3108 | 2013-09-26 |
| 1710160791 | Rebecca Meek | Nurse Practitioner | 469 Lewiston Rd, Grovetown, GA 30813 | 2007-12-12 |
| 1538677679 | Kimberly Queen | Nurse Practitioner | 101 Fornum Dr, Grovetown, GA 30813-2697 | 2018-01-10 |
| 1558740704 | Colette Vincent | Nurse Practitioner | 3001 Gordon Hwy, Grovetown, GA 30813-3808 | 2015-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093316820 | Odyne Rose Lacossiere-dorvilus | Nurse Practitioner | 30 Myrtlewood Dr, Savannah, GA 31405-1024 | 2020-11-06 |
| 1104427061 | Tya Wright | Nurse Practitioner | 1450 Newnan Crossing Blvd E Apt 13205, Newnan, GA 30265-0027 | 2020-11-05 |
| 1235730409 | Cheryl Lynn Williams | Nurse Practitioner | 282 Somerset Dr, Dallas, GA 30132-9761 | 2020-11-04 |
| 1033710298 | Karen F Frazier | Nurse Practitioner | 6610 Crest Wood Ln, Douglasville, GA 30135-9046 | 2020-11-04 |
| 1619578986 | Marjorie Sewannyana | Nurse Practitioner | 553 Camano Way, Mcdonough, GA 30253-8377 | 2020-11-03 |
| 1639770027 | Markesha Leshea Groomes | Nurse Practitioner | 209 N. Cuthbert, Colquitt, GA 39837-3515 | 2020-11-03 |
| 1265033625 | Ashley Thomas | Nurse Practitioner | 3750 Venture Dr Ste E4, Duluth, GA 30096-1863 | 2020-11-03 |
| 1558962894 | Anna Marie Kodama | Nurse Practitioner | 462 Furys Ferry Rd # C, Augusta, GA 30907-9506 | 2020-11-03 |
| 1093315848 | Tracy Tarvers | Nurse Practitioner | 129 Wolf Creek Dr N, Macon, GA 31210-9002 | 2020-10-30 |
| 1346840089 | Opal Glorien Bayonne | Nurse Practitioner | 3430 Maple Terrace Dr, Suwanee, GA 30024-2487 | 2020-10-30 |
| Find all providers with the same taxonomy | ||||
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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.