Basic Information
Provider Information
NPI: 1427335165
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZELAYA
FirstName: BRITTANY
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: PAAA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WEST
OtherFirstName: BRITTANY
OtherMiddleName: V
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PAAA
OtherLastNameType: 1
Mailing Information
Address1: 3155 N POINT PKWY STE F100
Address2:  
City: ALPHARETTA
State: GA
PostalCode: 300055495
CountryCode: US
TelephoneNumber: 7706459181
FaxNumber: 7706458455
Practice Location
Address1: 1000 JOHNSON FERRY RD NE
Address2:  
City: ATLANTA
State: GA
PostalCode: 303421606
CountryCode: US
TelephoneNumber: 7706459181
FaxNumber: 7706458455
Other Information
ProviderEnumerationDate: 11/09/2011
LastUpdateDate: 10/05/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000X006309GAY Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


Home