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

Tina Chinwenwa Ezeh

Individual provider Psychiatric/Mental Health Clinical Nurse Specialist · NPI 1740996222

Tina Chinwenwa Ezeh is a Nurse Practitioner in Douglasville, Georgia. Qualified in 2022, 4 years ago. Practices with Personal Recovery Network LLC, a 605-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2023

Practice location Address checks out

5945 Azalea Ridge Dr
Douglasville, GA 30135-5590
Phone: (770) 882-8673
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Clinical Nurse Specialist (primary) Taxonomy 364SP0808X · Licence RN259954 (GA)

Record details

NPI number1740996222
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 27, 2023
Last updated in NPPESAugust 26, 2025
Certification dateAugust 26, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Personal Recovery Network Llc — 605 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount