Ivy Akua Fenin, NP
Nurse Practitioner in Austell, GA. Individual provider (NPI-1).
NPI number1780039131
StatusActive
Last updated in NPPESMar 27, 2024
Details
- NPI
- 1780039131
- Entity type
- Individual (NPI-1)
- Name
- Ivy Akua Fenin
- Credential
- NP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 3, 2016
- Certification date
- Mar 27, 2024
- Last updated
- Mar 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | RN185101 | GA | Yes |
| 207Q00000X | Family Medicine | RN185101 | GA |
Practice location
4120 Austell RdAustell, GA 30106-1841
Phone 678-732-1500
Mailing address
Po Box 102038Atlanta, GA 30368-2038
Other practice locations
563 Greyhawk Way
Fairburn, GA 30213-4618
Fairburn, GA 30213-4618
Phone 678-577-9287
3116 Highway 34 E
Newnan, GA 30265-1342
Newnan, GA 30265-1342
Phone 678-732-1521
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