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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

FANESHIA PETERSON, FNP

Deactivated

FANESHIA PETERSON, FNP is a Family Nurse Practitioner healthcare provider located in ELLENWOOD, Georgia. NPI 1942898473 is deactivated in the NPPES registry. Verify at CMS.

Family Nurse Practitioner · ELLENWOOD, GA

This NPI has been deactivated. The record was deactivated on January 20, 2021. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1942898473
Provider Type
Individual
Gender
Female
NPI Issued
Jan 11, 2021 (0.024657534246575 yrs)
Last Updated
Nov 1, 2025
Deactivated
Jan 20, 2021
Licenses
APRN-NP259066 (GA)
259066 (GA)

Practice Information

Address
4475 W VILLAGE PKWY
ELLENWOOD, GA, 302942869
Browse GA providers · Browse ZIP 30294
Phone
7705077950
Primary Specialty
Family Nurse Practitioner
363LF0000X
Additional Specialty
Registered Nurse

Other Family Nurse Practitioner Providers in ELLENWOOD, GA

Name Credential NPI
MRS. TERRILYN D LEMONS APRNP 1336304682
KATHLEEN C HAYNES FNP 1992065718
SIAMECO CURTIS NP-C 1710386313
TAMARIA DUNN FNP-C 1992108328
TREVINO C SIMMONS FNP 1346797065
SHALUNDRAH MCINTIRE 1326588104
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.