Individual provider · Type 1 NPI

Elissa Gloria Fontenot, NP

Nurse Practitioner · Lithonia, GA

NPI number 1386229839 Active

Practice location

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996

Mailing address

105 Princeton Ct
Covington, GA 30016-2953

Specialties and licenses

TaxonomyCodeLicense
General Practice Registered Nurse 163WG0000XRN241909 (GA)
Nurse Practitioner Primary 363L00000XNCO-000003 (GA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1386229839

Elissa Gloria Fontenot, NP's National Provider Identifier is 1386229839, issued on Mar 16, 2021. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Lithonia, GA. The record was last updated on Mar 16, 2021.