Abraham, Rennie Juanillo

Abraham, Rennie Juanillo is an individual health care provider with primary practice located at 275 Collier Rd Nw Suite 290, Atlanta GA 30309-1709. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Abraham, Rennie Juanillo can be contacted via phone (404) 352-3300.

Contact Information

Primary practice address
275 Collier Rd Nw Suite 290 Atlanta GA 30309-1709
Phone: (404) 352-3300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN204958 Georgia

Profile Details

NPI number 1669740783
LBN Legal business name Abraham, Rennie Juanillo
Credentials FNP, NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 3rd, 2011
Last updated Sep 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669740783 NPPES
Georgia MEDICAID 003139537A

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