Individual
AZEEZAT ABISOLA SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
5965 PARKWAY NORTH BLVD STE C, CUMMING, GA 30040-1431
(770) 886-5700
(770) 886-0404
Mailing address
5965 PARKWAY NORTH BLVD STE C, CUMMING, GA 30040-1431
(770) 886-5700
(770) 886-0404
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN63096
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN-NP263096
GA
Other
Enumeration date
12/13/2022
Last updated
10/23/2025
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