Basic Information
| Provider Information | |||||||||
| NPI: | 1467967497 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAESAR | ||||||||
| FirstName: | CLAUDINE | ||||||||
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| Credential: | FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 RIVERWOOD PKWY SE STE 250 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303393304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4706153389 | ||||||||
| FaxNumber: | 7709554278 | ||||||||
| Practice Location | |||||||||
| Address1: | 211 FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | ELLENWOOD | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302942721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709975714 | ||||||||
| FaxNumber: | 7709975728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2017 | ||||||||
| LastUpdateDate: | 03/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | RN152471 | GA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology | 363LF0000X | RN152171 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.