KOLISHA DEE DANIELS (NPI# 1720447493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720447493 |
| Entity Type | Individual |
| Full Name | KOLISHA DEE DANIELS |
| Credential | NP |
| Practice Address |
1200 Lower Fayetteville Rd Ste B Newnan GA 30265 |
| Mailing Address |
1355 Peachtree St Ne Ste 1600 Atlanta GA 30309-3276 |
| Practice Telephone | 6786314610 |
| Practice Fax Number | 6786314611 |
| Mailing Telephone | 6782237774 |
| Mailing Fax Number | 6782237799 |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2018-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
RN213104 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003175704D | 05 | |
| GA | 003175704A | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1260 Highway 54 W Ste 103, Fayetteville, GA 302144525 | 7704867000 | 7704867010 |
| 2401 Newnan Crossing Blvd E, Ste 110, Newnan, GA 302652408 | 6786314610 | 6786314611 |
| Street Address |
1200 LOWER FAYETTEVILLE RD STE B |
| City | NEWNAN |
| State | GA |
| Zip Code | 30265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497918627 | Bharat K Puchakayala | Internal Medicine | 1200 Lower Fayetteville Rd Ste B, Newnan, GA 30265 | 2008-07-08 |
| 1750853271 | Kayla Jean Jones | Nurse Practitioner | 1200 Lower Fayetteville Rd Ste B, Newnan, GA 30265-1133 | 2018-12-21 |
| 1528473964 | Mustafa Haroon | Internal Medicine | 1200 Lower Fayetteville Rd Ste B, Newnan, GA 30265-1133 | 2014-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265041537 | Shiva Bazargan | Pharmacist | 3116 Sr 34 West, Newnan, GA 30265 | 2020-07-23 |
| 1992322549 | Doctorsbeyond Inc. | Clinic/Center | 277 Skyview Court, Newnan, GA 30265 | 2020-06-30 |
| 1225652936 | Jerrica Conyers | Nurse Practitioner | 1635 Highwat 34 East Suite C, Newnan, GA 30265 | 2020-05-29 |
| 1982234688 | Morgan Elizabeth Bross | Physician Assistant | 1825 Ga- 34, Newnan, GA 30265 | 2020-01-22 |
| 1013553379 | Hopebridge LLC | Behavior Technician | 2147 Newnan Crossing Boulevard East, Newnan, GA 30265 | 2019-11-21 |
| 1518528116 | Stepping Stones Psychiatric Care LLC | Nurse Practitioner | 3025 Sharpsburg Mccullum Rd, Building B Suite 103, Newnan, GA 30265 | 2019-06-25 |
| 1356823363 | Stephen William Jacon | Specialist/Technologist | 29 Muirfield Court, Newnan, GA 30265 | 2018-09-05 |
| 1881176832 | Blueprint Psychiatry, LLC | Psychiatry & Neurology | 1601 Highway 34 E Ste A, Newnan, GA 30265 | 2018-09-05 |
| 1548790769 | Timothy Collins | Physical Therapist | 1755 Ga-34, Suite 1300, Rehab Department, Newnan, GA 30265 | 2017-06-20 |
| 1497289748 | Edible Health & Wellness,llc | Clinic/Center | 90f Glenda Trace Pmb 318, Newnan, GA 30265 | 2017-04-13 |
| Find all providers in zip 30265 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336394238 | Tammy Thompson Rabern | Nurse Practitioner | 128 Millard Farmer Ind Blvd, Newnan, GA 30263-1090 | 2008-11-20 |
| 1750853271 | Kayla Jean Jones | Nurse Practitioner | 1200 Lower Fayetteville Rd Ste B, Newnan, GA 30265-1133 | 2018-12-21 |
| 1558726935 | Amy Rollins | Nurse Practitioner | 600 Celebrate Life Pkwy, Newnan, GA 30265-8001 | 2015-12-29 |
| 1992137475 | Megan Louise Fenceroy | Nurse Practitioner | 600 Parkway N, Newnan, GA 30265-8000 | 2013-08-06 |
| 1033412168 | Jessica Isaac | Nurse Practitioner | 600 Parkway N, Newnan, GA 30265-8000 | 2010-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154110 | Christina Danielle Palau Vaccari | Nurse Practitioner | 712 Pasley Ave Se, Atlanta, GA 30316-2158 | 2020-11-07 |
| 1427657113 | Cynthia Diane Prather | Nurse Practitioner | 3264 Lower Boston Rd, Thomasville, GA 31757-1311 | 2020-10-22 |
| 1932706728 | Alecia Ann Czarnecki | Nurse Practitioner | 6240 Crooked Creek Dr, Rex, GA 30273-5006 | 2020-10-05 |
| 1801401112 | Cotenna D. Clark | Nurse Practitioner | 1857 Cameo Ct, Tucker, GA 30084-7002 | 2020-09-14 |
| 1487264370 | Helen Young Yates | Nurse Practitioner | 40 Red Rock Ct Ne, Ludowici, GA 31316-6280 | 2020-08-05 |
| 1982214334 | Jasmine Alecia Henderson | Nurse Practitioner | 52 Roseberry Cir, Port Wentworth, GA 31407-5612 | 2020-07-31 |
| 1275142994 | Theresia Richardson | Nurse Practitioner | 2033 Buford Hwy Ste 109, Buford, GA 30518-8802 | 2020-07-28 |
| 1063021277 | Elsa Duncan Duncan | Nurse Practitioner | 1822 E Gwinnett St, Savannah, GA 31404-1853 | 2020-07-24 |
| 1154941946 | Joy P Wharton | Nurse Practitioner | 182 Silver Arrow Cir, Austell, GA 30168-7490 | 2020-04-21 |
| 1235769985 | Michelle Brack | Nurse Practitioner | 502 Hall Rd, Thomasville, GA 31757-8105 | 2020-01-22 |
| Find all providers with the same taxonomy | ||||
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| 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.