Individual provider Active NPI

Fnu Brunhilda, NP

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1487416897
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN301414 Issued in GA
Practice address
3527 Memorial Dr Unit W
Decatur, GA 30032-2731
Phone
(404) 573-4844
NPI assigned
Jan 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN301414 GA Primary

Addresses

Primary practice location

3527 Memorial Dr Unit W
Decatur, GA 30032-2731

Mailing address

2770 Clary Trce NE
Roswell, GA 30075-5419

Other names 1

  • Fnu Ngwisah Brunhilda Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250203000270 GA Practitioner - Nurse Practitioner 7719416965 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Longleaf Hospice LLCGroup PAC ID 6305904939, 4 clinicians

Practice addresses (Care Compare)

Covington, GA 30014
Phone (770) 939-9179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN301414GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Green Haven Hospice and Palliative Care, LLC CurrentSince Oct 5, 2025 Accepting new patients
Longleaf Hospice, LLC Family Medicine CurrentSince Dec 16, 2024 Accepting new patients

Locations

1160 Monticello St SW
Ste 200
Covington, GA 30014
Phone (770) 824-3200

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1487416897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 CLARY TRCE NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3527 MEMORIAL DR UNIT W",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300322731",
            "telephone_number": "404-573-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNHILDA",
        "first_name": "FNU",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN301414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FNU",
            "last_name": "BRUNHILDA",
            "middle_name": "NGWISAH",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.