Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Mid Provider Inc

Organization Gerontology Nurse Practitioner · NPI 1962621532

Mid Provider Inc provides Gerontology Nurse Practitioner services 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 Not confirmed with CMS for 16 years — call before visiting
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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