Individual
CHIAZOR EZIAKOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, PMHNP-BC, FNP-C
Contact information
Practice address
265 BOULEVARD NE, ATLANTA, GA 30312-1208
(770) 948-4512
Mailing address
265 BOULEVARD NE, ATLANTA, GA 30312-1208
(770) 948-4512
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F06162151
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2019082358
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN189319
GA
Other
Enumeration date
07/02/2016
Last updated
05/22/2020
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