Provider Demographics
NPI:1679463277
Name:BREATHON MEDICAL INC
Entity type:Organization
Organization Name:BREATHON MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIANAH
Authorized Official - Middle Name:O
Authorized Official - Last Name:ADEKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:678-933-4323
Mailing Address - Street 1:1808 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-4700
Mailing Address - Country:US
Mailing Address - Phone:678-933-4323
Mailing Address - Fax:
Practice Address - Street 1:1808 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-4700
Practice Address - Country:US
Practice Address - Phone:678-933-4323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty