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

Carly Alicia Fuqua, NP-C

Individual provider Nurse Practitioner · NPI 1366260770

Carly Alicia Fuqua, NP-C is a Nurse Practitioner in Cumming, Georgia. Qualified in 2021, 5 years ago. Practices with Northside Cardiovascular Professional Services, LLC, a 142-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
5
Licensed in
GA
In the registry since
2024
What do these letters mean?
NP-C — Nurse Practitioner, Certified
A nurse practitioner certified by the AANP.

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Practice location Address checks out

2000 Howard Farm Dr Ste 450
Cumming, GA 30041-6085
Phone: (404) 845-8200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN240849 (GA)

Record details

NPI number1366260770
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP-C
Sole proprietorNo
NPI enumeratedOctober 3, 2024
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northside Cardiovascular Professional Services, Llc — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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