Basic Information
| Provider Information | |||||||||
| NPI: | 1760476949 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CRUEL | ||||||||
| FirstName: | VERNENDIA | ||||||||
| MiddleName: | ANNE | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 PEACHTREE NEST 1600 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303082246 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048811094 | ||||||||
| FaxNumber: | 4048741249 | ||||||||
| Practice Location | |||||||||
| Address1: | 1800 HOWELL MILL RD NW | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303182538 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043519512 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2005 | ||||||||
| LastUpdateDate: | 09/24/2015 | ||||||||
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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 | 363L00000X | RN145300NP | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.