Mabell Nathalia Agudelo

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Atlanta, GA

NPI 1124547385 · NPPES record last updated Sep 19, 2017

Key facts

NPI
1124547385
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
270 Carpenter Dr Ste 400
Atlanta, GA 30328-4933
Phone
(678) 460-0345
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Family Ties Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

270 Carpenter Dr Ste 400
Atlanta, GA 30328-4933

Mailing address

270 Carpenter Dr Ste 400
Atlanta, GA 30328-4933

Other providers in Atlanta, GA

All providers in Atlanta, GA · Student in an Organized Health Care Education/Training Program in Georgia

Sources for this page

Verify at the official NPI Registry.