Provider Demographics
NPI:1487335873
Name:MOREAU, NADIA CAROLE (RN)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:CAROLE
Last Name:MOREAU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1870 THE EXCHANGE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2021
Mailing Address - Country:US
Mailing Address - Phone:470-231-9505
Mailing Address - Fax:
Practice Address - Street 1:1870 THE EXCHANGE SE STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2021
Practice Address - Country:US
Practice Address - Phone:470-231-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA23149576291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory