Basic Information
Provider Information
NPI: 1659682789
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TURCO
FirstName: MELANIE
MiddleName: L.
NamePrefix:  
NameSuffix:  
Credential: WHNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6285 BARFIELD RD NE
Address2: STE 250
City: ATLANTA
State: GA
PostalCode: 303284335
CountryCode: US
TelephoneNumber: 4043031224
FaxNumber: 4043031325
Practice Location
Address1: 5445 MERIDIAN MARKS RD NE
Address2: STE 430
City: ATLANTA
State: GA
PostalCode: 303424763
CountryCode: US
TelephoneNumber: 4042525196
FaxNumber: 4042522414
Other Information
ProviderEnumerationDate: 06/23/2010
LastUpdateDate: 05/06/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LX0001XRN116035GAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology

No ID Information.


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