DIANE BOULAI (NPI# 1437442803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437442803 |
| Entity Type | Individual |
| Full Name | DIANE BOULAI |
| Credential | LPN |
| Practice Address |
5524 Old National Hwy Suite B College Park GA 30349-3212 |
| Mailing Address |
525 Mica Trce College Park GA 30349-8479 |
| Practice Telephone | 4047638555 |
| Practice Fax Number | 4047638502 |
| Mailing Telephone | 4047638555 |
| Mailing Fax Number | 4047638502 |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | LPN061853 | GA | Nursing Service Providers |
| Street Address |
5524 OLD NATIONAL HWY SUITE B |
| City | COLLEGE PARK |
| State | GA |
| Zip Code | 30349-3212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225232440 | Lisa M Hewitt-geer | Social Worker | 5524 Old National Hwy, Building B, Suite 150-a, College Park, GA 30349 | 2007-06-12 |
| 1164768537 | Nicole Chavannes | Registered Nurse | 5524 Old National Hwy, Ste B, College Park, GA 30349-3341 | 2012-12-12 |
| 1477800993 | Darrell M Brooks | Counselor | 5524 Old National Hwy, Ste B, College Park, GA 30349-3212 | 2012-08-15 |
| 1396092953 | Andre Mcdaniel | Counselor | 5524 Old National Hwy, Ste B, College Park, GA 30349-3212 | 2012-08-13 |
| 1073887899 | Carla Warrick | Social Worker | 5524 Old National Hwy, Ste B, College Park, GA 30349-3212 | 2012-02-24 |
| 1174802029 | Mary Botchey | Registered Nurse | 5524 Old National Hwy, Ste B, College Park, GA 30349-3212 | 2011-08-10 |
| 1942589734 | June Mitchell | Registered Nurse | 5524 Old National Hwy, Ste B, College Park, GA 30349-3212 | 2011-08-10 |
| 1700179637 | Monica Denise Borum | Licensed Practical Nurse | 5524 Old National Hwy, Suite B, College Park, GA 30349-3212 | 2011-05-25 |
| 1023301405 | Kira S Bradley | Counselor | 5524 Old National Hwy, College Park, GA 30349-3212 | 2011-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376185686 | Kmb Diagnostics | Durable Medical Equipment & Medical Supplies | 941 Flat Shoals Rd, Atlanta, GA 30349 | 2019-10-09 |
| 1114575859 | Justin Vassell | Registered Nurse | 1903 Phoenix Boulevard, Suite 200, College Park, GA 30349 | 2019-08-27 |
| 1841856663 | Kennyetta Danielle Watkins | Counselor | 1431 Riverwalk Ln, Apt. F, College Park, GA 30349 | 2019-05-16 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1669971875 | Ee Consulting Solution | Case Management | 6320 Topaz Tral, Arlanta, GA 30349 | 2018-02-03 |
| 1629595640 | Shayla Bouie | Contractor | 5420 Riverdale Rd Apt D17, Atlanta, GA 30349 | 2017-08-30 |
| 1114475563 | Jasmine V Mccully | Social Worker | 5864 Summergien Lane, College Park, GA 30349 | 2016-09-14 |
| 1639537681 | Shelia Thornton | Counselor | 5856 Seabright Lane, Atlanta, GA 30349 | 2016-02-05 |
| 1346610177 | Joanne Resilard | Nurse Practitioner | 2931 Herron Ln Sw, Atlanta, GA 30349 | 2015-10-06 |
| 1063805091 | Southwest Atlanta Medical & Rehabilitation Clinic LLC | Family Medicine | 495 85 Circle, Suite 100, Atlanta, GA 30349 | 2015-03-16 |
| Find all providers in zip 30349 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124370903 | Randolph Asama Anagho | Licensed Practical Nurse | 4709 Caddo Rd, College Park, MD 20740 | 2012-10-04 |
| 1588825822 | Michelle L Bigelow | Licensed Practical Nurse | 2147 Shancey Ln, College Park, GA 30349-3427 | 2008-06-19 |
| 1245303817 | Pamela Denise Martin | Licensed Practical Nurse | 1920 John Wesley Ave, College Park, GA 30337 | 2006-11-15 |
| 1720411523 | Louis Afumbom Kimeng | Licensed Practical Nurse | 4920 Niagara Rd, Suite 318, College Park, MD 20740-1110 | 2013-08-15 |
| 1285071878 | Emile Cheuyou Youmbi | Licensed Practical Nurse | 4920 Niagara Rd Ste 318-320, College Park, MD 20740-1110 | 2013-05-23 |
| 1700179637 | Monica Denise Borum | Licensed Practical Nurse | 5524 Old National Hwy, Suite B, College Park, GA 30349-3212 | 2011-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961557 | Christina Jarvis-reid | Licensed Practical Nurse | 211 Lasso Dr, Riverdale, GA 30274-4095 | 2020-10-28 |
| 1326646639 | Yolanda Glover-harden | Licensed Practical Nurse | 6214 Hickory Lane Cir, Union City, GA 30291-5509 | 2020-10-09 |
| 1831706423 | Sonia Dareus | Licensed Practical Nurse | 1495 Cain Ct N, Douglasville, GA 30134-3681 | 2020-09-28 |
| 1609482140 | Antronette Darrell | Licensed Practical Nurse | 1578 Cherry Hill Rd Sw, Conyers, GA 30094-6835 | 2020-09-21 |
| 1760097778 | Christal Latrice Callier | Licensed Practical Nurse | 1995 Matt Dr, Austell, GA 30168-4330 | 2020-09-15 |
| 1356955678 | Marica Lashone Sanders | Licensed Practical Nurse | 301 -3 Club Villa Court, Kathleen, GA 31047 | 2020-09-03 |
| 1689287641 | Lydia Gennie | Licensed Practical Nurse | 1004 Shoreline Dr, Bainbridge, GA 39817-8393 | 2020-08-28 |
| 1558972588 | Starla Lynn Waddell | Licensed Practical Nurse | 675a Moran Lake Rd Ne, Rome, GA 30161-2106 | 2020-08-13 |
| 1700495975 | Shalunda Harrison | Licensed Practical Nurse | 4311 Christine Ct, Decatur, GA 30035-1702 | 2020-07-23 |
| 1902414683 | Vernita Monica Washington | Licensed Practical Nurse | 1974 Talmadge Rd, Allenhurst, GA 31301-3201 | 2020-07-17 |
| Find all providers with the same taxonomy | ||||
| City | COLLEGE PARK |
| Zip Code | 30349 |
Please comment or provide details below to improve the information on DIANE BOULAI.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.