Provider Demographics
NPI:1578678686
Name:PINCKNEY, ANNMARIE OLIVET IVERINE (NP)
Entity type:Individual
Prefix:MRS
First Name:ANNMARIE
Middle Name:OLIVET IVERINE
Last Name:PINCKNEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:1800 HOWELL MILL RD NW STE 800
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-0922
Mailing Address - Country:US
Mailing Address - Phone:678-298-3239
Mailing Address - Fax:404-477-1162
Practice Address - Street 1:775 POPLAR RD STE 310
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-8303
Practice Address - Country:US
Practice Address - Phone:770-251-2590
Practice Address - Fax:770-251-1490
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN333841363LA2200X
NYF302383363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0747G1Medicare ID - Type Unspecified
Q26594Medicare UPIN