Organization · Type 2 NPI
Providence Healthcare of Georgia
Home Health Registered Nurse · Mableton, GA
NPI number
1720618077
Active
Practice location
6509 Bennington Bluff Ct
Mableton, GA 30126-7269
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Home Health Registered Nurse Primary | 163WH0200X | None listed |
| Case Management Agency | 251B00000X | None listed |
| Home Health Agency | 251E00000X | None listed |
| Nursing Care Agency | 251J00000X | None listed |
| Community/Behavioral Health Agency | 251S00000X | None listed |
| In Home Supportive Care Agency | 253Z00000X | None listed |
Home Health Registered Nurse: Definition to come...
About NPI 1720618077
Providence Healthcare of Georgia's National Provider Identifier is 1720618077, issued on Jan 24, 2020. The primary taxonomy on file is Home Health Registered Nurse (163WH0200X), and the practice location is in Mableton, GA. The record was last updated on Sep 26, 2025.