Transcription
APRN Delegating Physician - Active Nurse Protocol AgreementsDelegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Aaron, StephanieRN116808 David Dean, MD64808 985495 Collier Rd, Suite 5015 Atlanta, GA 30309Abbey, Ophelia AliceRN215132 Gertrude Arrington, MD27036 209981720 Phoenix Blvd Ste. 900&600 College Park, GA 30349Abbey, OpheliaRN215132 Sherica Rosser, MD61157 156653459 Holcomb Bridge Rd, Ste 100 Norcross, GA 30092Abbey, Ophelia AliceRN215132 Melinda Willingham, MD45669 138724112 E. Ponce De Leon Ave. Clarkston, GA 30021Abdullahi, AntoinetteRN236531 Freeman Montaque, MD28123 13606896 Highway East McDonough, GA 302528/7/2014Abebe, MahletRN221110 Karl Mihalvotis, MD11776 207704015 South Cobb Drive Smyrna, GA 300806/9/2017Abel, Janinne MarieRN24342724288 20722104 Moore Street- Murdy Hall Oxford, GA 300547/13/2017Abera, Abebe FentawRN207642 Elisabeth Barclay, MD56406 19185250 Georgia Avenue SE ste. 206 Atlanta, GA 3031212/1/2016Abernathy, Taylor MRN205283 Santanu Das, MD42560 138711049 N. Houston Rd. Warner Robins, GA 310939/11/2014Abernathy, DeborahRN079832 Schaefer, Timothy MD47524 106881700 Hospital South Drive, Ste 500 Austell, GA 30106Abid, MarthaRN192840 Nelson Yuen, MD63984 164022292 Peachtree Rd NW Atlanta, GA 30309Abid, MarthaRN192840 Jeremy Ackerman, MD59584 152491364 Clifton Rd NE Altanta, GA 30322William Little, MDWednesday, November 08, /20155/8/2015Page 1 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Abiodun, DolapoRN186519 Armando Salazar, MD73055 157535151 Brook Hollow Pkwy, Ste 145 Norcross, GA 30071Abiri, Autherine NnkeonyelumRN121276 Susanne Hardy, DO69860 213271364 Clifton Rd. NE Atlanta, GA 30322Abraham, SibyRN248131 Asha Parikh, MD28850 186123280 Old Alabama Rd. Johns Creek, GA 30022Abraham, Linda M.RN178502 Jonathan Ehrlich, MD15580 12325993-D Johnson Ferry Rd, Suite 360 Atlanta, GA 30342Abraham, Rennie JuanilloRN204958 Josephine Lopez, MD44125 116471500 Oglethorpe Ave, Suite 100 Athens, GA 3Abramson, Cara RothfieldRN108696 Daniel Dubovsky, MD29866 134555670 Peachtree Dunwoody Rd, Ste 1100 Atlanta, GA 30342Absalom, Kaci LaDawnRN177275 Edward Matthews, DO34896 118642300 Manchester Expwy, Ste 2001 Columbus, GA 319092/5/2015Acree, Lisa PinkardRN126710 Reden Delgado, MD65957 20821501 Redmond Rd. Rome, GA 301654/7/2017Acree, LisaRN126710 Darshak Pandya, DO58995 15634501 Redmond Rd Rome, GA 301656/4/2015Acton, PatriciaRN124420 Winston, Alan Daniel MD41245 10018200 South Enota, Suite 380 Gainesville, GA 305011/6/2012Adams, Jina CraveyRN093180 Lawton Davis, MD21669 3936789 Telfair Avenue McRae Helena, GA 3105511/2/2017Adams, Angela DeanneRN158173 Gordon Waters, MD52849 38909396 Kingsland Drive Folkston, GA 315378/31/2017Adams, Margaret WycheRN220456 Lee Herman, MD43644 174704365 Johns Creek Pkwy, Ste 400 Suwanee, GA 300244/1/2016Adams, Angela DeanneRN158173 Nimi Patel, DO67582 174632101 Tebeau St Waycross, GA 315014/1/2016Adams, Jamie ElizabethRN240230 Anu Murthy, MD54867 171793350 Riverwood Pkwy SE, Ste 2050 Atlanta, GA 303392/4/2016Wednesday, November 08, e 2 of 6397/10/2014
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Adams, Mary AllisonRN191947 Morgan Wood, MD32681 16641367 Clear Creek Pkwy Lavonia, GA 30553Adams, MatthewRN176258 Anthony Captain, MD39300 158842955 Cleveland Hwy, Ste A Dalton, GA 307217/9/2015Adams, KelliRN164623 Dean Karampelas, MD26141 15695743 Spring St NE Gainesville, GA 305016/4/2015Adams, Holly ScottRN176923 Paul Guichard, DO54386 1196355 Whitcher St, Suite 350 Marietta, GA 300607/11/2013Adams, Jewel AnnRN079253 Donald Davis, MD19506 77261525 Clifton Road Atlanta, GA 3032210/2/2012Adams, Jennifer CampbellRN157995 James Lindley, MD33138 79084 Jackson Blvd Savannah, GA 3140512/3/2010AdamsRN219584 Safia Pirani, MD56624 387663330 Peachtree Corners Circle, Suite H Peachtree Corners, GA 300928/31/2017Adamski, Jennifer LynnRN226384 Gregory Bumberbatch, MD66772 17015285 Boulevard NE, Ste 415 Atlanta, GA 30312Adamski, JenniferRN226384 Dean Karampelas, MD26141 13842743 Spring St Gainesville, GA 305019/11/2014Adamski, Jennifer LynnRN226384 Dean Karampelas, MD26141 11780743 Spring St Gainesville, GA 305014/4/2013Adcock, Leslie HollowellRN063419 William Morris Brown, MD29309 885595 Collier Rd, Suite 5015 Atlanta, GA 303091/7/2010Adderley, KishaRN185219 Crystal Hood, MD58813 386661506 Klondike Rd. Conyers, GA 30094Adderley, GildaRN191759 Susan Schayes, MD43278 156592124 Candler Rd Decatur, GA 303106/4/2015Adderley, KishaRN185219 Sheryl Canady, MD50999 155431775 Parker Rd, Ste C-240 Conyes, GA 300946/4/2015Addison, Nivenann TownsendRN114338 Michael Connor, MD31581 5020725 Jesse Jewell Pkwy, Suite 200 Gainesville, GA 305015/6/2011Wednesday, November 08, 201711/6/20152/4/20168/10/2017Page 3 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Addy, Sharon N.RN218443 Edward Matthews, MD34896 112382525 Williams Rd. Columbus, GA 31909Adebayo, Monsurat Modupe ARN144155 Brooks Moore, MD53336 1978149 Jessie Hill Jr. Drive ste. 127 Atlanta, GA 303032/2/2017Adebayo, Omotola AdukeRN136921 Deslyn Olunuga, MD73906 170081670 Clairmont Rd Decatur, GA 300331/7/2016Adebayo, Monsurat M.RN144155 Jada Bussey-Jones, MD47306 1121880 Jesse Hill Jr. Dr. SE Atlanta, GA 30303Adegbuji, OmoronkeRN161498 Lakshmi Gopireddy, MD65244 16262575 Dacula Rd Dacula, GA 300199/3/2015Adegbuji, OmoRonkeRN161498 Cedrella Jones-Taylor, MD26313 149081670 Clairmont Rd Decatur, GA 300332/5/2015Adegbuji, Omoronke Olufunmil RN161498 Madhu Vishwanath, MD56499 8869595 Piedmont Ave, Suite 1000 Atlanta, GA 30308Adekoya, Christianah Omoyemi RN211077 Kimberly Gilbert, MD62848 194605100 West St. Covington, GA 300143/9/2017Adekoya, ChrisianahRN211077 Ritz Claxton, MD66584 145001133 Eagles Landing Pkwy Stockbridge, GA 665845/8/2015Adeshigbin, Alaba RisikatRN175655 Stephen Dayan, MD68888 182124425 Memorial Drive Decatur, GA 300328/4/2016Adeshigbin, AlabaRN175655 Lloydstone Jacobs II, MD49179 109492980 University Parkway Lawrenceville, GA 300438/10/2012Adeshigbin, Alaba RisikatRN175655 Lee Grose, MD46856 222900 University Parkway Lawrenceville, GA 3004511/1/2007Adewumi, Ugochi N.RN222309 Richard Blalock, MD70233 20045868 York Ave, SW Atlanta, GA 30310-27503/9/2017Adeyemi, Afusat OmolaraRN202394 Shelly Yusuff, MD49482 171391844 Old Norcross Rd, Ste 200 Lawrenceville, GA 300444/1/2016Adeyemo, Oluwatoke AbidemiRN175909 Patrick Meloy, DO69897 18707550 Peachtree Street Atlanta, GA 30308Wednesday, November 08, 201712/7/201211/2/201212/4/200910/6/2016Page 4 of 639
APRN NameRN#Delegating PhysiciaAdham, Sarah ChristinRN208832 Douglas Stuart, MDPHY#Protocol #Protcol AddressEffective35527 947595 Collier Rd, Suite 4045 Atlanta, GA 3030911/5/2010Adibe, Josephine Obiy Onwujek RN111866 Raman Damineni, MD43915 166821670 Clairmont Rd Decatur, GA 3003311/6/2015Adjei, Vincentia AsantewahRN201559 Vitaliy Gavrikov, MD61430 212762551 Roswell Rd. ste. 415 Marietta, GA 300628/10/2017Adjei, Vincentia AsantewahRN201559 Kobina Wilmot, MD68577 204326340 Sugarloaf Parkway ste. 200 Duluth, GA 30097Adkins, Jessica RRN168399 Kasey Berman, MD55095 13809400 Mall Blvd Ste.410B Savannah, GA 31406Adkins, India MarcellRN183996 Eric Hall, MD45814 11965512 South Main St, Suite A Hinesville, GA 31313Adkins, Amelia Rose CraigheadRN117328 Robersteen Howard, MD40103 24330 Turner McCall Blvd, Suite 4000 Rome, GA 301659/14/2007Adkinson, Lauren AaronRN181617 Frank Casey, MD59614 125195400 Bowman Rd Macon, GA 3121011/8/2013ADOFO, MARGARETRN256346 STEVE GARST - MD48047 3923310905 HAYNIE BRIDGE RD ALPHARETTE, GA 3002211/2/2017Adofo, MargaretRN256346 Patricia Kelly, MD48528 21330424 Decatur St, SE Decatur, GA 303128/10/2017Adofo, MargaretRN256346 Arlene Wilson, MD30926 19394268 Lawrence St. Marietta, GA 3006011/4/2016Aerstin, Monica ChristineRN131199 Andrew Darlington, DO71597 17203745 Poplar Rd Newnan, GA 30265Aerstin, Monica ChristineRN131199 Hassan Sayegh, MD36066 19595 Collier Rd, Suite 300 Atlanta, GA 303099/13/2013Afolabi, Wuraola BukolaRN210974 Alvin Jackson, MD66163 19230106 E Broad St. Savannah, GA 3140111/4/2016Agbor, EbangaRN226655 Charles Moore, MD30655 207484550 Cobb Parkway Acworth, GA 301017/13/2017Wednesday, November 08, 20175/4/20179/11/20146/7/20133/3/2016Page 5 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Agnew, GretaRN054192 Titu Das, MD61838 153596335 Hospital Parkway, Ste 310 John Creek, GA 300975/8/2015Agomessou, Ablavi AdodoRN214710 Tracy Nailor, MD44659 197441625 Pleasant Hill Rd. ste. 215 Duluth, GA 300962/2/2017Agomessou, Ablavi AdodoRN214710 Willie Tapp, MD51746 182981700 Medical Way Snellville, GA 300787/7/2016Agyemang, Dora AgyeiRN158183 Frank Bynes, MD36932 12702106 East Broad St Savannah, GA 314011/9/2014Agyemang, William O. B.RN154407 Eric Fogam, MD47902 9138PO Box 7150 Garden City, GA 3141810/8/2010Agyepong, Dorothy DeeRN109364 Samar Shah, MD75245 192561111 Bullsboro Dr, Ste 6&7 Newnan, GA 3026511/4/2016Agyepong, Dorothy DeeRN109364 Apal L. Hartman, MD50887 175592000 10th Ave, Ste 400 Columbus, GA 319015/5/2016Agyepong, Dorothy DeeRN109364 Clyde Simmons, MD17301 151085488 Alabama Ave Omega, GA 317753/5/2015Ahearn, Nanci Lee BrinnRN211307 Douglas Perry, MD40753 1316489 Interchange Dr Richmond hill, GA 313244/4/2014Ahearn, Nanci Lee BrinnRN211307 Wallace Holland, MD24438 964710055 Ford Ave, Suite 5A Richmond Hill, GA 313243/4/2011Ahle, SusanRN218166 Ryan Moody, MD59284 180625353 Reynolds St. 4 South Savanah, GA 314058/4/2016Aiello, LisaRN196588 Shelly McIntyre, MD74005 39104129 South Main Street, Suite C Hiawassee, GA 30546Aina, Joanrn15365617274 105281255 Highway 54 West Fayetteville, GA 302143/1/2012Ajayi, Abisola AyodeleRN210095 Celia Mamby, MD39529 197305700 Hillandale Dr., Ste 250 Lihonia, GA 300588/4/2016Ajiboye-Lala, Oyeronke OmoyeRN201907 Crystal Nelson, MD66157 19276125 Governs Square Peachtree City, GA 3026911/4/2016Robinowitz, Michael MDWednesday, November 08, 201710/5/2017Page 6 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Akins, Scott JRN231437 Khurram Khan, MD67490 192275673 Peachtree-Dunwoody Rd, Ste 500 Atlanta, GA 3034211/4/2016Akins, Katharine L ReevesRN081701 David Brantley, MD28506 13512200 North River St. Claxton, GA 304177/10/2014Akinyele, OlajumokeRN224730 Brian Barczak, MD76418 210002900 Chamblee Tucker Rd. Bldg 16 Atlanta, GA 303417/13/2017Akram, HibbaRN223987 Eric Awad, MD35203 388882045 Peachtree Rd, NE Suite 333 Atlanta, GA 303098/31/2017Alaka, Olushola DenaiRN165259 Olatunde Idowu, MD57374 189713950 Austell Rd Ste. Box 22 Austell, GA 3010610/6/2016Alaka, Olushola DenaiRN165259 Melissa Schepp, MD50221 14504677 Church St. Marietta, GA 300609/11/2014Alaka, Olushola DenaiRN165259 Melissa Schepp, MD50221 123905665 Peachtree Dunwoody Rd NE Atlanta, GA 30342Alamu, Ikeade BelloRN211052 Jada Moore-Ruffin, MD57395 38741235 Central Ave. Atlanta, GA 303038/31/2017Alamu, Ikeade BelloRN211052 Lawrence Powell, MD38915 168314120 Austell Rd. Austell, GA 3010612/3/2015Albritton, Amber LaineRN174507 Alan Brown, MD57782 19037417 West Third Ave, Ste 500 Albany, GA 3170610/6/2016Alcius, Martine ElietteRN195292 Josephine Tan, MD19193 12701106 East Broad St Savannah, GA 31401Alday, Vicky W.RN061053 Jennifer Miller, MD46996 8081390 E H Court Brunswick, GA 31520Alderman, Troy DrawdyRN212358 Jorge Pisarello, MD58914 13091701 North Slappey Blvd Albany, GA 31701Alderman, TroyRN212358 Gutierrez, Raymond MD57983 10892701 N. Slappey Blvd Albany, GA 317017/12/2012Aldridge, Katie LakeRN230220 Don Heacock, MD37564 38856791 Poplar Street Macon, GA 312018/31/2017Wednesday, November 08, 201710/10/20131/9/201411/1/20074/4/2014Page 7 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Alegre-Guzman, Melisss HaydeRN257239 Maria Walker, MD25306 18745Ales, Lisa MarieRN119193 Charles Johnson, MD7504Alexander, GilesRN134977 Charles Moore, MD30655 391774550 Cobb Parkway, NW Suite 101 Acworth, GA 3010110/5/2017Alexander, Shona RasheedaRN168429 Guy Lemire, MD61284 3885811340 Lakefield Drive, Suite 200 Johnscreek, GA 300978/31/2017Alexander, MarrianRN179472 Eric Fan, MD49615 211611102 Smith Avenue Thomasville, GA 317928/10/2017Alexander, Langley LeeRN192808 Wykena Jackson, MD62124 213731670 Clairmont Rd Decatur, GA 300338/10/2017Alexander, Crystal ShantaeRN262128 Emily Feely, MD60831 1982815151 Alcovy Rd. Covington, GA 300142/2/2017Alexander, Shona RasheedaRN168429 Margaret White, MD36482 33500 Springhouse Circle Stone Mountain, GA 300878/5/2011Alexander, Gary RichardRN059514 Robert Hall, MD45234 29619 S. 8th St. ste. 200 Griffin, GA 30224-426011/1/2007Alexis-Destin, BernadetteRN198438 Harmon Smith, MD41486 391221301 Sigman Road, Suite 230 Conyers, GA 3001210/5/2017Alexis-Destin, BernadetteRN198438 Ray Paris, MD19855 14382101 Commerce Place Barnesville, GA 3020410/9/2014Alford, Susan AshleyRN227426 Thomas Williamson, MD42144 388916005 Waltson Blvd, Suite 100 Byron, GA 310088/31/2017Alfors, Suzanne MarieRN256415 Barbara McElhanon, MD69354 184711605 Chantilly Dr, Ste 305 Atlanta, GA 303248/4/2016Alfors, Suzanne MarieRN256415 April Landry, MD73849 187031605 Chantilly Dr, Ste 305 Atlanta, GA 303248/4/2016Alfors, Suzanne MarieRN256415 Davon Simon, MD58644 183801605 Chantilly Dr, Ste 305 Atlanta, GA 303246/9/2016Wednesday, November 08, 2017118865040 Snapfinger Woods Dr., Ste 108 Decatur, GA 300359/1/20166392 Murphy Dr Morrow, GA 302605/3/2013Page 8 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Algozin, Anna Livia YearousRN217018 Andrew Leach, MD49051 18816355 Hawthorne Lane Athens, GA 30606Al-Haroun, Katherine MeltonRN188235 Melody Palmore, MD33679 12631341 Ponce de Leon Ave Atlanta, GA 30308Ali, Natalie ReneeRN132742 Christina Oskins, MD74153 204631012 Burleyson Rd. Dalton, GA 307205/4/2017Ali, Idris PashaRN229841 Christopher Oldfield, MD46195 120691326 Eisenhower Dr Savannah, GA 314068/9/2013Aliffi, Kathy Jeanette CastilleRN089463 Nathan Neufeld, DO70135 12615600 Parkway North Newnan, GA 3026512/6/2013Aliffi, Kathy Jeanette CastilleRN089463 George Vellanikaran, MD33219 3620 Francis Way, Suite 101 Sharpsburg, GA 3027710/4/2007Aliotta, Brandy TaylorRN142957 William Osborne, MD33664 374750 Waters Avenue, Suite 400 Savannah, GA 31404Allain, Lauren C.RN225178 Marc J. Harringan, MD56719 1140435 Collier Rd., Ste 500 Atlanta, GA 30309Allard, Wendy DanielsRN219105 Daniel McKinney, MD59477 17601705 Dixie St. Carrollton, GA 301775/5/2016Allcott, Mary Alice GiblinRN052669 Michael Sharkey, MD38609 8182510 East Oglethorpe Hwy Hinesville, GA 313134/3/2008Allen, Renai A.RN222518 Michael Fortson, MD35051 386654398 Atlanta Highway Loganville, GA 30052Allen, Terrie HattieRN195025 Jeffrey Metts, MD68070 19632600 Celebrate Life Parkway Newnan, GA 302651/5/2017Allen, Jane NixRN072414 Stratton Kearns, MD32218 19705597 South Enota Dr. Gainesville, GA 305011/5/2017Allen, Jane NixRN072414 Tod Bethea, MD42016 194092578 Helen Hwy Cleveland, GA 30528Allen, Vivian LynnRN134633 Lori Trefts, MD66093 186322500 Starling St, Ste 503 Brunswick, GA 31520Wednesday, November 08, 1/20168/4/2016Page 9 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Allen, Michelle MarieRN184598 Carisa Hines, MD50637 18521774 GA Hwy 96 Bonaire, GA 310058/4/2016Allen, Pamela LashunRN247091 Amar Singh, MD52227 16663550 Redmond Rd Rome, GA 3016511/6/2015Allen, SonyaRN077192 Mark Elam, MD36147 15949755 S Perry St 2nd floor Lawrenceville, GA 300468/6/2015Allen, HarriettRN185582 Jack Dawson, MD11945 159791968 Peachtree Rd NW Atlanta, GA 303098/6/2015Allen, JacobRN195213 William Blincoe, MD23018 158161968 Peachtree Rd NW Atlanta, GA 303097/9/2015Allen, MaryRN058026 Anna Woodbury, MD67188 155691670 Clairmont Rd Decatur, GA 300336/4/2015Allen, JeanieRN087452 Paul Giles, MD25159 156371006 Mt Vernon Highway Vidalia, GA 304746/4/2015Allen, Sonya M.RN077192 Bill Moore Smith, MD59963 15412755 South Perry St., 2nd Flr Lawrenceville, GA 300465/8/2015Allen, Renai ARN222518 Tamer Middleton, Md51987 153552988 Shallowford Rd. Marietta, GA 300664/2/2015Allen, Mary ChandlerRN233995 Meenakshi Hari, MD49026 153422520 Windy Hill Rd, Ste 104 Marietta, GA 300674/2/2015Allen, Terrie HattieRN195025 George Arimah, MD42787 15160121 Northcrest Blvd. Macon, GA 312103/5/2015Allen, Jane NixRN072414 Glendon Rougeou, MD70764 13440108 Prominence Ct Ste 100 Dawsonville, GA 305349/11/2014Allen, Jane NixRN072414 Robert Kelly, MD34384 124275875 Thompson Mill Rd, Suite 100 Hoschton, GA 3054812/6/2013Allen, Jane NixRN072414 Terry Hansen, MD47330 48184-A Professional Dr Baldwin, GA 305115/3/2013Allen, Amber BethRN184309 Virginia Price, MD19897 9914705 Dallas Hwy, Suite 101 Villa Rica, GA 301809/1/2011Wednesday, November 08, 2017Page 10 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Allen, Nancy Leigh WardRN065074 William Adcox, MD31376 52100 Genevieve Court, Suite A Fayetteville, GA 302153/4/2011Allen, Bryan PatrickRN162545 Carl Foster, MD57618 88526400 Flat Rock Rd Columbus, GA 319074/1/2010Allen, Deborah C.RN190740 Rose Cesar, MD48217 89271497 Fair Rd, Suite 201 Statesboro, GA 304582/5/2010Allen, Beth AnnRN081047 Joseph Watlington, MD25685 8124201 Thomas Road Ft. Oglethorpe, GA 3074212/7/2007Allen, Beth AnnRN081047 Lindsay Crawford, MD56531 42614 Patterson Road Lafayette, GA 3072812/7/2007Allibhoy, RozinaRN172068 Aziz Pirani, MD61934 192284025 Lawrenceville Hwy, ste A Lilburn, GA 3004711/4/2016Allicock, Alisa NatashaRN198722 Andrew Magnet60215 14277813 E 68th St, Ste B Savannah, GA 3140111/7/2014Allman, Danielle Kristin ReneeRN226437 Vida Reklaitis, MD34718 124981000 Johnson Ferry Rd, Emer Dept Atlanta, GA 3034212/6/2013Allman, Danielle Kristin ReneeRN226437 Deborah Griffiths, MD35888 122891000 Medical Center Blvd, Emer Dept Lawrenceville, GA 300469/13/2013Allman, II, Michael AlanRN191921 Christopher Walls, MD31854 170394700 Waters Ave Savannah, GA 314052/4/2016Allmond, LynnRN111386 Martha Terris, MD43056 161811120 15th St BA-8414 Augusta, GA 309129/3/2015Almburg, Lauren AlyssaRN235362 James Lee, DO56583 17759310 Gold Creek Trail, Ste 200 Woodstock, GA 301886/9/2016Almeida, Susan Marie206603Sreekanth Reddy, MD49476 186601505 Northside Blvd. ste. 4600 Cumming, GA 300419/1/2016Almeida, TammyRN175707 Davis Reames lV, MD##### 142654 Jackson Blvd Savannah, GA 31405Almeida, Tammy ReneeRN175707 Troy Murphy, DO53290 124519 Chatham Center South, Suite C Savannah, GA 31405Wednesday, November 08, 201711/6/20151/9/2014Page 11 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#ALONZO, ALICE MARIERN149944 GURURAJ NAYAK MD44033 392351110 HILLCREST PKWY DUBLINE, GA 3102111/2/2017Alonzo, Alice MarieRN149944 Gururaj Nayak, MD44033 391901110 Hillcrest Parkway, Suite C Dublin, GA 310219/23/2017Alonzo, Alice MarieRN149944 David Cox, MD70247 168521111 Griffin Ave, Ste A & B Eastman, GA 310231/7/2016Alston, Marion Elfriede PloetzRN087708 Marlene Shivers, MD33236 17184121 Burgess Rd Brunswick, GA 315206/9/2016Alston, MarionRN087708 Trefts, Lori MD66093 104842500 Starling St, Ste 503 Brunswick, GA 315203/1/2012ALTMAN, KERIRN213457 RICHARD CHASE - DO17784 39239705 HUDSON AVE ASHBURN, GA 3171411/2/2017Altman, Keri LynnRN213457 Walter Rios Corujo, MD75099 39056705 Hudson Avenue Ashburn, GA 3171410/5/2017Altman, Keri LynnRN213457 Teddi Virgil, MD75936 38742705 Hudson Avenue Ashburn, GA 317148/31/2017Altman, Keri LynnRN213457 Mariel Hepburn, MD74668 19818907 E. 18th Street Tifton, GA 317942/2/2017Altman, Keri LynnRN213457 James Graham,MD30071 198172225 US Hwy. 41 N. Tifton, GA 317942/2/2017Altman, Keri LynnRN213457 Langston Cleveland, MD46584 179684468 Union Rd. Tifton, Ga 317947/7/2016Altringer, Joanne May GenselRN131761 Michelle Perry, MD53017 140842040 Dan Proctor Dr., Ste 250 St Marys, GA 3155810/9/2014Amaker, IrisRN041284 Riba Kelsey-Harris, MD53833 593740 Cascade Road Atlanta, GA 3033112/4/2008Amankwah, Pearl OpokuaRN195776 Courtney Shelton, MD50559 13232315 Boulevard NE, Suite 200 Atlanta, GA 303125/1/2014Amanti, Michael GerardRN234264 Morgan McLemore, MD59290 1399280 Jesse Hill Jr Dr. SE, Ground Atlanta, GA 303039/11/2014Wednesday, November 08, 2017Page 12 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Amara, AliceRN229290 Preetesh Patel, MD54631 163001295 Hembree Rd, Ste 105 Roswell, GA 300769/3/2015Amason, Jeryi Lyn PankovRN100568 Laurence Lesser, MD14194 137092160 Fountain Drive, Ste 5 Snellville, GA 300789/11/2014Amato, Juliet ReneeRN186569 Baker, Roy MD25096 102134 Jackson Blvd Savannah, GA 3140512/1/2011Amatriain, Valerie ReneeRN091643 Deborah Griffiths, MD35888 621000 Medical Center Blvd, Emer Dept Lawrenceville, GA 30046Amazon, Jody LeeRN096082 Jae Pak, MD40185 93962160 Fountain Dr, Suite 200 Snellville, GA 30078Amazon-Leece, Jody LeeRN096082 Naresh Parikh, MD28851 636330 Primrose Hill Court Norcross, GA 300922/5/2009Amba, Katheryne TifuhRN208577 Robert Cook, MD26087 12123707 Old Dalton Elijay Rd, Emer Dept Chatsworth, GA 307058/9/2013Amidei, TinaRN147435 Paul Guichard, DO54386 2100155 Whitcher Street, Suite 350 Marietta, GA 300607/13/2017Amos, Karen DeniseRN213486 Olufemi Taiwo, MD51606 21238222 Arrowhead Blvd. Jonesboro, GA 302368/10/2017Amougou, Yves-Aime Amougou RN212975 Vanderlyn Sewell, MD51547 21084934 Briarcliff Rd. NE Atlanta, GA 303068/10/2017Amukamara, ErnestRN201832 Sallu Jabati, MD58572 154875615 Old National Highway, Ste D College Park, GA 30349An, Eun JiRN224478 Angelina Cain, MD71103 2100255 Whitcher Street, Suite 400 Marietta, GA 300607/13/2017An, Eun JiRN224478 Chang Soo Kim, MD59806 172853590 Peachtree Industrial Blvd Duluth, GA 300963/3/2016Anaele, Caroline ChikaRN135346 James Rogan, MD37662 166492121 Fairburn Rd, Ste B Douglasville, GA 3013511/6/2015Anaele, CarolineRN135346 David Wyatt, MD42979 158862121 Fairburn Rd, Ste B Douglasville, GA 301357/9/2015Wednesday, November 08, 20178/9/201311/5/20106/4/2015Page 13 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Anaele, Caroline Chika ObasiRN135346 Luzmira Torres, MD54287 118692121 Fairburn Rd, Suite B Douglasville, GA 30135Anderson, Melissa PollockRN162737 Stephen Rubendall57320 3937990 E Stephens Street Camilla, GA 3173011/2/2017Anderson, JustinRN207284 Parviz Brahman, MD66576 391761401 South Main Street Moultrie, GA 3176810/5/2017Anderson, BethanyRN243182 Jonathan Allen, MD56949 388531900 Tebeau St. Waycross, GA 315018/31/2017Anderson, GeraldineRN115669 Srilatha Nadipineni, MD65851 20981401 East 4th Avenue Cordele, GA 310157/13/2017Anderson, MelissaRN162737 Kristopher Palmer, MD75974 20629915 Gordon Avenue Thomasville, GA 317927/13/2017Anderson, Kymberly DawnRN149756 Harsh Singh, MD57844 20098204 East 15th Street Alma, GA 315104/7/2017Anderson, JeanneRN238134 Moiz Master, MD54088 2012812 Sammy McGhee Blvd, Ste 101 Jasper, GA 301433/9/2017Anderson, Justin WayneRN207284 Hewatt Sims, MD48965 198121622 Madison Ave Tifton, GA 317942/2/2017Anderson, Melissa PollockRN162737 James Palazzolo, MD37637 198262002 Palmyra Rd, Ste 101 Albany, GA 317012/2/2017Anderson, Karen BealeRN101306 Sreevalli Dega, MD71063 197205629 Hwy 21 South Rincon, GA 313261/5/2017Anderson, Jessica TanksleyRN175466 Eugene Cindea, MD33053 19421725 Jesse Jewell Pkwy SE Gainesville, GA 30501Anderson, Justin WayneRN207284 Michael Schmidt, MD58500 18750454 Smith Avenue Thomasville, GA 317929/1/2016Anderson, Karen BealeRN101306 Sidney James Morgan, MD75139 18870105 Rocky Ford Rd. Sylvania, GA 304679/1/2016Anderson, Christa SmithRN129289 Melissa Warner, MD33480 17760310 Black Bear Ridge Sautee, GA 305716/9/2016Wednesday, November 08, 20175/3/201312/1/2016Page 14 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Anderson, Stephanie HeatonRN173488 George Michael, MD54532 17615391 East Main St, Historic Hawkins Bldg Canton, GA 301145/5/2016Anderson, Lisa DasherRN220834 Roger Beville, MD28377 174481000 B North Veterans Blvd Glennville, GA 304274/1/2016Anderson, Letitia BelindaRN176811 William Chafin, MD67542 17295957 Baxter St. Athens, GA 306063/3/2016Anderson, Jessica TanksleyRN175466 Michael Maley, MD34410 1720730 Cottonwood St Clayton, GA 305253/3/2016Anderson, Justin WayneRN207284 James Brown, MD51025 16851454 Smith Ave Thomasville, GA 317921/7/2016Anderson, Tabatha14979142766 16701676 Historic Hwy 441 N. Demorest, GA 3053512/3/2015Anderson, Laura HillRN189512 Ira Knepp, MD34002 166512740 Ray Knight Way, Ste 100 Albany, GA 3170711/6/2015Anderson, LauraRN189512 Michael Satchell, MD49593 164232822 Nottingham Way, Ste 4 Albany, GA 3170710/1/2015Anderson, TatianaRN170864 James Rheudasil, MD26926 145215673 Peachtree Dunwoody Rd, Ste 675 Atlanta, GA 303424/2/2015Anderson, Geraldine JacksonRN115669 Sheila Southerland, MD55894 13180902 7th Street North Cordele, GA 310155/1/2014Anderson, Sherry LRN107552 David Celestial, DO54990 7757610 19th st Columbus, GA 31901-15289/13/2013Anderson, Karen BealeRN101306 Sidney Morgan, Jr, MD21262 74105 Rocky Ford Rd Sylvania, GA 304673/8/2013Anderson, Christine G.RN139756 Harold D. Hubert, MD635511376820 St. Sebastian Way, Ste *-A Augusta, GA 3090112/7/2012Anderson, Tabatha P.RN149791 Kecia J. Jones, MD55247 11286638 Historic Hwy 441, Ste. B Demorest, GA 3053511/2/2012Anderson, Stephanie HeatonRN173488 Anderson, Michael MD54532 77391 East Main street Canton, GA 301114Nancy Watson, MDWednesday, November 08, 20171/6/2012Page 15 of 639
Protocol #Protcol AddressEffectiveRN#Anderson, GeraldineRN115669 Jones, Ernest DO41851 10194216 Hospital Drive Cordele, GA 3101511/3/2011Anderson, Christopher JamesRN105862 Sidney Smith, MD38615 71900 Mohawk St Savannah, GA 314194/1/2011Anderson, Alana Dee AustinRN146734 Andrew Michas, MD49065 93071001 N. Monroe Street Albany, GA 317019/2/2010Anderson, Cynthia LynneRN127974 Tonya Fordham, DO49292 8937277 Lackawanna Street Baxley, GA 315131/7/2010Anderson, Caroline CarterRN154703 Harrison Carter, MD50575 86961126 West 12th Street Alma, GA 31510Anderson, Christine GayleRN139756 Mark Smith, MD37908 701303 D'Antignac Street, Suite 2500 Augusta, GA 30901Anderson, Tasha LCRN183773 Robert Dambach, DO30039 784720 Nelson Brogdon Blvd Sugar Hill, GA 3051812/7/2007Anderson-Finch, Sheena25231446773 1671813570 N. Main St. Trenton, GA 3075212/3/2015Anderson-Parris, Mary AnnRN122052 Yanire Nieves, MD36657 184731701 Hardee Ave. SW Atlanta, GA 303108/4/2016Anderson-Parris, Mary AnnRN122052 Ranjan Avasthi, MD63164 1652183 Upper Riverdale Rd Riverdale, GA 302742/4/2016Anderson-Reid, MarleneRN178688 Ernest Han, MD62511 11532663 Lanier Park Dr. Gainesville, GA 305011/11/2013Andler, Pamela Joy SalettRN157084 Nydia Maria Bladuell, MD38429 7955 Whitcher St, Suite 350 Marietta, GA 300604/13/2007Andres, Garland R. S.RN159210 Sherry Taylor, MD35151 84835780 P'tree Dunwoody Rd, #295 Atlanta, GA 30342Ashely##### 38658Andrews, LeannaDelegating PhysiciaPHY#APRN NameJose Justiniano-Ayla, MDAnil PiyaRN191140 Prima Foster, MDWednesday, November 08, 201757619 3896011/5/20093/7/20084/2/20098/10/20156400 FlatRock Road Columbia, GA 319078/31/2017Page 16 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Andrews, AshleyRN169449 Anil Paya,MD73134 387135102 E. Paulsen Street Savannah, GA 314058/10/2017Andrews, LekitaRN218896 Ram Subramanian, MD59210 210041365 Clifton Road, NE Bldg B6, Suite 6400 Atlanta, GA 303227/13/2017Andrews, Rachel AleanRN169747 John Wood, MD59239 19415777 Hemlock St. Macon, GA 3120112/1/2016Andrews, NancyRN238281 Jeff Wilkins, MD51402 150943421 Mike Padgett Hwy Augusta, GA 309063/5/2015Andrews, Regina LynnRN154122 Raj Gupta, MD33345 12188308 Coliseum Dr, Suite 120 Macon, GA 312178/9/2013Anekwe, JacintaRN223904 Ike Nwaobi, MD65038 20848601 South 8th Street Griffin, GA 30224Angevine, Margaret McGarrityRN246634 Jose Ruiz-Lagos, MD63948 1593335 Collier Rd, Ste 635 Atlanta, GA 303097/9/2015Ansley, DianeRN4631864679 181972605 Parkwood Dr. Brunswick, GA 315209/1/2016Anthony, Joy AliciaRN262252 Aubrey Cawthon, MD74318 193301200 Memorial Drive Dalton, GA 3072012/1/2016Anuforo, Sylvanus AmanzeRN175316 Jean Phillipe-Dambreville,MD44056 19426315 Boulevard NE Atlanta, GA 3031212/1/2016Anyanwu, Justina NgoziRN156181 Sharon Tuckett, DO36309 159404028 Hwy 5 Douglasville, GA 301357/9/2015Anyaoha, Forstina NnekaRN120012 Rao Prasad55640 20532677 Church St Marietta, GA 300605/4/2017Anyaoha, Sheila OgochukwuRN216652 Madhavi Jordan, MD56725 1901155 Whitcher St, Ste130 Marietta, GA 30060Anyaoha, Forstina NnekaRN210012 Tariq Noohani, MD66975 16135677 Church St. Marietta, GA 30060Apara, Margret OmobolanleRN196401 Kevin Johnson, MD70497 38667665 Duluth Highway Lawrenceville, GA 30046Michele McMahon, MDWednesday, November 08, 20177/13/201710/6/20168/6/20158/10/2017Page 17 of 639
Delegating PhysiciaPHY#Protocol #Protcol AddressEffectiveAPRN NameRN#Aplin, Brooke JohnsonRN138437 James Cox, MD34323 886918 McGinnis Ferry Road Suwanee, GA 300243/7/2008Appiah-Kubi, MavisRN185422 Yolanda Hacker, MD45811 13329855 Veterans Memorial Hwy SE Mableton, GA 301266/6/2014Arabshahi, FarnazRN151189 Meenakshi Thirunavu, MD73662 186166335 Hospital Pkwy, Ste 109 Johns Creek, GA 300979/1/2016Archer, Orchid M.RN185226 Emile Risby, MD30869 391582450 Vinson Highway, Cook Bldg. ste. O1 Milledgeville, GA 31062Archer, HollyRN124097 Holmes Marchman, MD37021 15968655 Jesse Jewell Pkwy SE, Ste B Gainesville, GA 305018/6/2015Archer, Ava DawnRN133688 Alison Krause, MD40443 91784040 Hospital West Drive Austell, GA 301068/6/2010Ard, CherylRN070092 Linda Arnold, MD40299 15696260 West Clinton St Gray, GA 310326/4/2015Ard, Cheryl J.RN070092 Hubert R. Smith, MD18745 11206412 Northside Dr., East Statesboro, GA 30458Arenas, Georgia Anne LualhatiRN257256 Fernando Molina, MD32111 196411825 Martha Berry Blvd. Rome, GA 30165Armand, Jean MarieRN183299 Dipan Patel, MD72396 1902580 Jesse Hill J
APRN Name RN# Delegating Physicia PHY# Protocol # Protcol Address Effective Adham, Sarah Christin RN208832 Douglas Stuart, MD 35527 9475 95 Collier Rd, Suite 4045 Atlanta, GA 30309 11/5/2010 Adibe, Josephine Obiy Onwujek RN111866 Raman Damineni, MD 43915 16682 1670 Clairmont Rd Decatur, GA 30033 11/6/2015 Adjei, Vincentia Asantewah RN201559 Vitaliy Gavrikov, MD 61430 21276 2551 Roswell Rd. ste .
