Individual
DANA PETERSEN HISCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
5671 PEACHTREE DUNWOODY RD, SUITE 700, ATLANTA, GA 30342-5000
(404) 847-9999
(404) 531-8466
Mailing address
5671 PEACHTREE DUNWOODY RD, SUITE 700, ATLANTA, GA 30342-5000
(404) 847-9999
(404) 531-8466
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN200031
GA
363LA2100X
Acute Care Nurse Practitioner
203502
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003145155A
—
GA
05
—
003145155B
—
GA
Enumeration date
07/13/2009
Last updated
01/11/2017
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