Provider Demographics
NPI:1548919103
Name:BELMAN, NIKOSAZANA ALAEZI (NP)
Entity type:Individual
Prefix:
First Name:NIKOSAZANA
Middle Name:ALAEZI
Last Name:BELMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:NIKOSAZANA
Other - Middle Name:
Other - Last Name:GREENE-ALAEZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2785 OLD NORCROSS RD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-2744
Mailing Address - Country:US
Mailing Address - Phone:678-908-4500
Mailing Address - Fax:
Practice Address - Street 1:1968 PEACHTREE RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1281
Practice Address - Country:US
Practice Address - Phone:404-605-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN318352363L00000X, 2084A2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No2084A2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurocritical Care