MIKAELA M PERIBONIO AGNP-C NPI 1811610553

NPI Information

  • NPI: 1811610553
  • Provider Name: MIKAELA M PERIBONIO, AGNP-C
  • Classification: Nurse Practitioner - 363LG0600X
  • Specialization: Gerontology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 5671 PEACHTREE DUNWOODY RD STE 900
    ATLANTA, GA
    ZIP 30342
  • Phone: (404) 847-9999

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NPI Details

Mikaela M Peribonio, AGNP-C is a gerontology nurse practitioner in Atlanta, GA with 1 years of experience. Mikaela M Peribonio, AGNP-C NPI is 1811610553. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduation Year:2024

The provider's business location address is:

5671 PEACHTREE DUNWOODY RD STE 900
ATLANTA, GA
ZIP 30342-022
Phone: (404) 847-9999

The NPI 1811610553 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/19/2022 and was last updated on 11/11/2024.

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
1363LG0600XNurse PractitionerGerontologyRN291729GEORGIAYes
2163W00000XRegistered NurseRN291729GEORGIANo

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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