Individual
MRS. MAVIS O. PEPRAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(404) 778-1900
(678) 843-6849
Mailing address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(404) 778-1900
(678) 843-6849
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN223668
GA
363LA2200X
Adult Health Nurse Practitioner
RN223668
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003213488A
—
GA
01
—
G08685A
MEDICARE PTAN
GA
Enumeration date
10/30/2018
Last updated
11/04/2025
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