Quanzetta B Habbeb-Ullah, NP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN076884 Issued in GA

Practice address

2011 Eisenhower Dr
Savannah, GA 31406-3905

Phone

(912) 356-2157

Fax

(912) 691-6807

NPI assigned

Apr 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Long County Board of Health

  • Public Health or Welfare Agency
  • Ludowici, GA
  • NPI 1174506737
  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1306809686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063901",
            "telephone_number": "912-356-2157",
            "fax_number": "912-691-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063905",
            "telephone_number": "912-356-2157",
            "fax_number": "912-691-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABBEB-ULLAH",
        "first_name": "QUANZETTA",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN076884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000816219B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Olivia Barbara Gwynn, BA, RBT
• Shabryia Gwynn
• H Clark Deriso M.D.P.C.
• H&W Enterprises of NC LLC
• Zachary Haas, D.O.
• George Gilbert Haberman, M.D.
• Habersham Dental of Savannah LLC
• Habersham Dental Partners, LLC
• Amanda Jane Haddad, MSN, CNM, WHNP-BC
• Daniel S. Haddad

• Women's Health Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Women's Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.