Provider Demographics
NPI:1174983696
Name:BHIMANI, SAMREEN I (NP-C)
Entity type:Individual
Prefix:
First Name:SAMREEN
Middle Name:
Last Name:BHIMANI
Suffix:I
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SAMREEN
Other - Middle Name:
Other - Last Name:LAKHANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1829 HEDGE ROSE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-2784
Mailing Address - Country:US
Mailing Address - Phone:404-201-0728
Mailing Address - Fax:
Practice Address - Street 1:FAMILY MEDICAL CLINIC OF LAWRENCEVILLE, LLC
Practice Address - Street 2:2522 CRUSE ROAD SUITE C-2
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044
Practice Address - Country:US
Practice Address - Phone:678-225-5540
Practice Address - Fax:678-225-5541
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN202217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily