Basic Information
Provider Information
NPI: 1407312812
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PLATNER
FirstName: CARINA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1605 CHANTILLY DR NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303243267
CountryCode: US
TelephoneNumber: 4047855437
FaxNumber:  
Practice Location
Address1: 1605 CHANTILLY DR NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303243267
CountryCode: US
TelephoneNumber: 4047855437
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/11/2019
LastUpdateDate: 06/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X25082TNN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health
363LP0808XRN299209GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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