DELIVERANCE HEALTH LIMITED LIABILITY COMPANY NPI 1124780861

NPI Information

  • NPI: 1124780861
  • Provider Name: DELIVERANCE HEALTH LIMITED LIABILITY COMPANY
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 108 CRESCENT WOODE DR
    DALLAS, GA
    ZIP 30157
  • Phone: (404) 934-6010

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NPI Details

DELIVERANCE HEALTH LIMITED LIABILITY COMPANY is a psychiatric/mental health nurse practitioner in Dallas, GA. DELIVERANCE HEALTH LIMITED LIABILITY COMPANY NPI is 1124780861. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

108 CRESCENT WOODE DR
DALLAS, GA
ZIP 30157-725
Phone: (404) 934-6010

The provider's authorized official is Ebote N Nnoko .
The authorized official title is Owner and has the following contact phone number (404) 934-6010.

The enumeration date for this NPI number is 10/11/2021 and was last updated on 10/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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