Individual
MS. NADINE ANGELA ENNIS
Active
Individual
MS. NADINE ANGELA ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.C.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004493
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
457877647A
—
GA
05
—
457877647B
—
GA
05
—
457877647C
—
GA
05
—
457877647D
—
GA
05
—
457877647E
—
GA
Enumeration date
11/07/2006
Last updated
09/27/2010
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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