Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mid Provider Inc

Organization Gerontology Nurse Practitioner · NPI 1962621532

Mid Provider Inc is a Gerontology Nurse Practitioner in Roswell, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1230 Worthington Hills Dr
Roswell, GA 30076-1753
Phone: (404) 229-0274
Fax: (770) 518-4026
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence RN133089 (GA)

Record details

NPI number1962621532
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Patricia Norris — Director · (404) 229-0274
NPI enumeratedApril 24, 2007
Last updated in NPPESJanuary 5, 2010
Mailing address1230 Worthington Hills Dr, Roswell, GA 30076-1753

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