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Individual

NICKETA BERNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3050
(404) 616-1000
Mailing address
1752 MISSELTHRUSH LN, MCDONOUGH, GA 30253-3083
(919) 928-3644

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN319192
GA
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN319192
GA
363LA2100X
Acute Care Nurse Practitioner
$$$$$$$$$
GA
363LA2100X
Acute Care Nurse Practitioner
APRN-NP319192
GA

Other

Enumeration date
07/15/2024
Last updated
04/30/2026
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