Individual provider · Type 1 NPI
Sandra I. Agazie
Psychiatric/Mental Health Nurse Practitioner · Fayetteville, GA
NPI number
1093506701
Active
Practice location
115 Bradford Sq Ste B
Fayetteville, GA 30215-1962
Fax (844) 870-7142
Mailing address
7586 Oldham Ln
Riverdale, GA 30274-3595
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | RN170528 (GA) |
| Adult Health Nurse Practitioner | 363LA2200X | RN170528 (GA) |
| Registered Nurse | 163W00000X | RN170538 (GA) |
| Medical-Surgical Registered Nurse | 163WM0705X | RN170538 (GA) |
| Primary Care Nurse Practitioner | 363LP2300X | RN170528 (GA) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | RN170528 (GA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1093506701
Sandra I. Agazie's National Provider Identifier is 1093506701, issued on May 13, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Fayetteville, GA. The record was last updated on Aug 25, 2026.