| Green Angel Healthcare Consulting, Inc. | |
|
4760 Austell Rd, Suite #3 Austell GA 30106-4007 | |
| (404) 452-2519 | |
| (678) 252-6427 |
| Full Name | Green Angel Healthcare Consulting, Inc. |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4760 Austell Rd, Suite #3, Austell, Georgia |
| Authorized Official Name and Position | Angella Dinina Green (OWNER) |
| Authorized Official Contact | 4044522519 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Angel Healthcare Consulting, Inc. 4760 Austell Rd, Suite 3 Austell GA 30106-4007 Ph: (404) 452-2519 | Green Angel Healthcare Consulting, Inc. 4760 Austell Rd, Suite #3 Austell GA 30106-4007 Ph: (404) 452-2519 |
| NPI Number | 1114303567 |
|---|---|
| Provider Enumeration Date | 08/08/2015 |
| Last Update Date | 12/18/2023 |
| Medicare PECOS PAC ID | 1658714894 |
|---|---|
| Medicare Enrollment ID | O20240205003481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114303567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 186231 (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Angella Dinina Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649729799 PECOS PAC ID: 7517141286 Enrollment ID: I20180524002367 |
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