Provider Demographics
NPI:1053554576
Name:NANA, HINA RAJESH (APRN)
Entity type:Individual
Prefix:
First Name:HINA
Middle Name:RAJESH
Last Name:NANA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6025 PROFESSIONAL PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-5609
Mailing Address - Country:US
Mailing Address - Phone:770-949-0555
Mailing Address - Fax:770-949-4424
Practice Address - Street 1:6025 PROFESSIONAL PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5609
Practice Address - Country:US
Practice Address - Phone:770-949-0555
Practice Address - Fax:770-949-4424
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN167533 NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner