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Organization
CONYERS WALK IN CLINIC
Active
Organization
CONYERS WALK IN CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE NICOLE WATERS FNP (OWNER/NURSE PRACTITIONER)
(770) 679-9935
Entity
Organization
Contact information
Practice address
1804 OVER LAKE DR SE, CONYERS, GA 30013-1788
(770) 679-9935
(770) 679-9938
Mailing address
1804 OVER LAKE DR SE STE A, CONYERS, GA 30013-1788
(770) 679-9935
(770) 679-9938
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
206177
GA
363LF0000X
Family Nurse Practitioner
RN206177
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306986427
—
GA
Enumeration date
07/29/2013
Last updated
10/07/2025
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