Individual
SHIVA EIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
5755 N POINT PKWY STE 34, ALPHARETTA, GA 30022-1144
(678) 240-0000
Mailing address
325 WINFORD PL, JOHNS CREEK, GA 30097-8447
(678) 430-2529
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN295702
GA
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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