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Contact Information

EVERGREEN PRIMARY CARE AND WELLNESS PC
2450 ATLANTA HWY STE 803
CUMMING, GA30040-1252
 Phone: 470-253-7944
 Fax: 678-807-6144
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for EVERGREEN PRIMARY CARE AND WELLNESS PC · (Female)

NPI Number 1285134999
Status Active
Credentials
Entity Individual
Enumeration date 02/19/2018
Last updated 03/08/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 52651
  • GA License # RN229572
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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