MRS. OCTAVIA MOORE HEDGE FNP-BC NPI 1174164289

NPI Information

  • NPI: 1174164289
  • Provider Name: MRS. OCTAVIA MOORE HEDGE, FNP-BC
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • Address: 1707 BLAIR BRIDGE RD
    AUSTELL, GA
    ZIP 30168
  • Phone: (678) 945-0700

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NPI Details

MRS. Octavia Moore Hedge, FNP-BC is a primary care nurse practitioner in Austell, GA. MRS. Octavia Moore Hedge, FNP-BC NPI is 1174164289. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1707 BLAIR BRIDGE RD
AUSTELL, GA
ZIP 30168-537
Phone: (678) 945-0700

The enumeration date for this NPI number is 10/1/2019 and was last updated on 11/29/2019.

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
1363LP2300XNurse PractitionerPrimary CareRN-147913-NPGEORGIAYes

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: 11/21/2025

NPI Synchronization or Removal

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