Provider Demographics
NPI:1760940761
Name:ZAWADZKI, CASEY BRIANNA (NP)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:BRIANNA
Last Name:ZAWADZKI
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:BRIANNA
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1109 BURLEYSON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3094
Mailing Address - Country:US
Mailing Address - Phone:706-272-6596
Mailing Address - Fax:706-370-7715
Practice Address - Street 1:1109 BURLEYSON RD STE 202
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3094
Practice Address - Country:US
Practice Address - Phone:706-272-6596
Practice Address - Fax:706-370-7715
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-08
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28388363L00000X, 363L00000X
GARN257763363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN28388OtherTN BOARD OF NURSING