Caroline Masanje, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95019079 Issued in CA

Practice address

177 Jubilee Blvd
Locust Grove, GA 30248-6027

Phone

(404) 545-8747

NPI assigned

Nov 22, 2021

Last updated

Nov 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1851058127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 JUBILEE BLVD",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302486027",
            "telephone_number": "404-545-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 JUBILEE BLVD",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302486027",
            "telephone_number": "404-545-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASANJE",
        "first_name": "CAROLINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95019079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• MG Lab Services LLC.
• MG Lab Services LLC.

• Family Nurse Practitioner in Locust Grove, GA
• Providers in Locust Grove, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; 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.