Individual provider Active NPI

Kristy Njaba Nanje

  • Psychiatric/Mental Health Nurse Practitioner
  • Powder Springs, GA
National Provider Identifier
1306615745
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN264275 Issued in GA
Practice address
5205 Olive Branch Cir
Powder Springs, GA 30127-3940
Phone
(678) 663-3124
NPI assigned
Dec 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN264275 GA Primary

Addresses

Primary practice location

5205 Olive Branch Cir
Powder Springs, GA 30127-3940

Mailing address

5205 Olive Branch Cir
Powder Springs, GA 30127-3940
Phone (678) 663-3124

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2001 N Lamar St
Suite 300
Dallas, TX 75202-1743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN264275GAMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1306615745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 OLIVE BRANCH CIR",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301273940",
            "telephone_number": "678-663-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 OLIVE BRANCH CIR",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301273940",
            "telephone_number": "678-663-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANJE",
        "first_name": "KRISTY",
        "middle_name": "NJABA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN264275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

Verify at the official NPI Registry.