Wall, Freda Ellen

Wall, Freda Ellen is an individual health care provider with primary practice located at 2001 Peachtree Rd Ne Ste 645, Atlanta GA 30309-1476. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Wall, Freda Ellen can be contacted via phone (404) 350-0106.

Contact Information

Primary practice address
2001 Peachtree Rd Ne Ste 645 Atlanta GA 30309-1476
Phone: (404) 350-0106
Fax: (404) 350-0176
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002766 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 002766 Georgia

Profile Details

NPI number 1063417608
LBN Legal business name Wall, Freda Ellen
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated Oct 22nd, 2007 - about 18 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 1063417608 NPPES
Other P00236158 RAILROAD MEDICARE

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