Ninoska Mercedes Bravo-Machado
Individual provider Active NPI Case Manager/Care Coordinator · Gainesville, GA
NPI 1972865202 · NPPES record last updated Jun 12, 2012
Key facts
- NPI
- 1972865202
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- License
- 419900792A (GA)
- Practice address
- 5424 Carolean St
Gainesville, GA 30506-3193 - Phone
- (678) 622-3801
- NPI assigned
- Jun 12, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 419900792A | GA | MD | Case Manager/Care Coordinator |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 419900792A | GA | Yes |
Addresses
Primary practice location
5424 Carolean St
Gainesville, GA 30506-3193
Mailing address
5424 Carolean St
Gainesville, GA 30506-3193
Phone (678) 622-3801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 419900792A | Medicaid | GA |
Other providers in Gainesville, GA
- Megan Branch
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- Tammy C Brannon
- Braselton Gainesville Emergency Department PC
- Davina Sara Braselton
- Breathe Better Allergy Asthma & Sinus Center, Inc
- Breathe Better Allergy, Asthma, and Sinus P.C.
- Marisa Christine Breen
- Martin L. Bremer
- Brenau Rehabilitation Practice Gainesvillephysical Therapy
All providers in Gainesville, GA · Case Manager/Care Coordinator in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.