Individual provider · Type 1 NPI

Faniska Massillon

Family Nurse Practitioner · Norcross, GA

NPI number 1093338733 Active

Practice location

PO Box 920095
Norcross, GA 30010-0095

Call (407) 308-9573 Map

Other practice locations

  • 2100 Riveredge Pkwy, Atlanta, GA 30328-4693 · (888) 445-8745

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XGAA-NP001583 (GA)
Family Nurse Practitioner 363LF0000XF346372-01 (NY)
Family Nurse Practitioner 363LF0000X95030305 (CA)
Family Nurse Practitioner 363LF0000XAPRN11006594 (FL)

Family Nurse Practitioner: Definition to come...

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About NPI 1093338733

Faniska Massillon's National Provider Identifier is 1093338733, issued on May 27, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Norcross, GA. The record was last updated on Sep 8, 2026.