Basic Information
| Provider Information | |||||||||
| NPI: | 1457356792 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIGUEROA | ||||||||
| FirstName: | RENEE | ||||||||
| MiddleName: | SUNSHINE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSN, APRN, BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 55 WHITCHER ST NE | ||||||||
| Address2: | STE 460 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300601171 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704277389 | ||||||||
| FaxNumber: | 7704272845 | ||||||||
| Practice Location | |||||||||
| Address1: | 55 WHITCHER ST NE | ||||||||
| Address2: | STE 460 | ||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300601171 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7704277389 | ||||||||
| FaxNumber: | 7704272845 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2005 | ||||||||
| LastUpdateDate: | 12/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | N | Other Service Providers | Specialist | 363L00000X | RN143128 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 003112818A | 05 | GA | MEDICAID | 003112818C | 05 | GA | MEDICAID | 003112818B | 05 | GA | MEDICAID | 003112818I | 05 | GA | MEDICAID | 003112818J | 05 | GA | MEDICAID | 003112818O | 05 | GA | MEDICAID | 003112818P | 05 | GA | MEDICAID | 003112818E | 05 | GA | MEDICAID | RN143128 | 01 | GA | ADULT NURSE PRACTITIONER | OTHER | 003112818L | 05 | GA | MEDICAID | 003112818D | 05 | GA | MEDICAID | 003112818F | 05 | GA | MEDICAID | 003112818G | 05 | GA | MEDICAID | 003112818H | 05 | GA | MEDICAID | 003112818K | 05 | GA | MEDICAID | 003112818M | 05 | GA | MEDICAID | 003112818N | 05 | GA | MEDICAID |