Provider Demographics
NPI:1073491551
Name:YOUR STORY MEDICAL SOLUTIONS LLC
Entity type:Organization
Organization Name:YOUR STORY MEDICAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:STORY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:706-664-1410
Mailing Address - Street 1:632 GARLAND TRL
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:GA
Mailing Address - Zip Code:30814-5152
Mailing Address - Country:US
Mailing Address - Phone:706-699-1738
Mailing Address - Fax:
Practice Address - Street 1:632 GARLAND TRL
Practice Address - Street 2:
Practice Address - City:HARLEM
Practice Address - State:GA
Practice Address - Zip Code:30814-5152
Practice Address - Country:US
Practice Address - Phone:706-699-1738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty