Provider Demographics
NPI:1376426239
Name:MONCADA, MERCEDES ELIZA (CPNP-PC)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:ELIZA
Last Name:MONCADA
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 SUWANEE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2059
Mailing Address - Country:US
Mailing Address - Phone:404-985-0771
Mailing Address - Fax:
Practice Address - Street 1:6286 OAKWOOD CIR
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1629
Practice Address - Country:US
Practice Address - Phone:678-248-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160859363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics