1073210407 NPI number — DANIELLE HAYGOOD APRN, FNP-C

Table of content: DANIELLE HAYGOOD APRN, FNP-C (NPI 1073210407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073210407 NPI number — DANIELLE HAYGOOD APRN, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAYGOOD
Provider First Name:
DANIELLE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073210407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1765 FOLSOM RD SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RYDAL
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30171-1753
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-767-1303
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1900 THE EXCHANGE SE STE 600
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30339-2050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-291-8987
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/15/2023

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  RN143272 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)