Terminated Nurse Protocol Agreements

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Terminated Nurse Protocol Agreements Terminated Nurse Protocol Agreements APRN Name RN# Delgating Physicia PHY# Protocol # Protcol Address Terminated Abebe, Mahlet M. RN221110 Jayesh Naik, MD 33253 20253 11111 Houze Rd., Ste 225 Roswell, GA 30076 4/18/2017 Abernathy, Pamela RN107241 Dark, Jennifer MD 66016 10682 1012 Burleyson Road Dalton, GA 30710 2/1/2017 Abernathy, Kari Elizabeth RN154956 Jaime Burkle, MD 48881 9783 309 Highland Pkwy, Suite 201 Ellijay, GA 30539 5/7/2012 Abiri, Autherine RN212591 Felix Amoa-Bonsu 55916 20369 5185 Old National Hwy College Park, GA 30349 6/7/2018 Abon, Moradeke RN141176 Albert Anderson, MD 58136 11082 341 Ponce deLeon Ave. Atlanta, GA 30308 8/24/2015 Abraham, Linda RN178502 Lynette Stewart, MD 39681 11113 3660 Flat Shoals Rd., Ste 180 Decatur, GA 30034 4/16/2013 Abraham, Linda RN178502 Hodges, Sharon MD 40759 10470 1372 Wellbrook Circle Conyers, GA 30012 3/30/2012 Abraham, Linda M. RN178502 Mohamad El-Attar, MD 41286 9546 1372 Wellbrook Cir NE Conyers, GA 30012 11/30/2011 Abraham, Linda M. RN178502 Phillip Bannister, MD 16503 5019 603-A Old Norcross Rd Lawrenceville, GA 30045 10/1/2010 Abramson, Cara Michelle Rothf RN108696 Thomas Seay, MD 30884 5 5670 P'tree Dunwoody Rd, #1100 Atlanta, GA 30342 6/16/2014 Acree, Lisa Pinkard RN126710 Melissa Dillmon, MD 54073 12389 255 West Fifth St Rome, GA 30165 4/1/2015 Wednesday, June 27, 2018 Page 1 of 410 APRN Name RN# Delgating Physicia PHY# Protocol # Protcol Address Terminated Acree, Lisa Pinkard RN126710 William Whaley, MD 11504 9 750 Deep South Farm Rd Blairsville, GA 30512 9/25/2014 Acree, Lisa RN126710 McCormick 25219 16688 501 Redmond Rd Rome, GA 30165 12/11/2015 Adams, Mary Allison RN191947 Brandon K. Hicks, MD 46683 41680 1230 Baxter Street Athens, GA 30606 3/26/2018 Adams, Jamie Elizabeth RN240230 Glenn Hittel, MD 34159 17603 150 Gentilly Blvd Cartersville, GA 30120 7/15/2016 Adams, Jamie RN240230 Yvonne Smith, MD 42443 16396 51 N Morning Side Dr Cartersville, GA 30121 1/3/2017 Adams, Jamie E RN240230 Christopher Sward, MD 45638 13737 150 Gentilly Blvd Cartersville, GA 30120 7/15/2016 Adams, Angela D. RN158173 Asit K. Jha, MD 55248 11189 1706 Alice St. Waycross, GA 31501 2/2/2016 Adams, Sherida RN181346 Knepp, Ira MD 34002 10276 1009 N. Monroe Street Albany, GA 31701 4/30/2012 Adamski, Jennifer Lynn RN226384 James Bailey, MD 28368 11645 743 Spring St Gainesville, GA 30501 4/30/2014 Adcock, Leslie Hollowell RN063419 Cullen Morris, MD 44285 18 1270 Prince Ave, Suite 303 Athens, GA 30606 9/18/2009 Adderley, Kisha RN185219 Sheryl Canady, MD 50999 15543 1775 Parker Rd, Ste C-240 Conyes, GA 30094 2/1/2017 Adegbuji, Omoronke Olufunmil RN161498 Noreen Andrews, MD 46861 7921 1910 Hwy 20 SE, Suite 270 Conyers, GA 30013 11/17/2009 Adeshigbin, Alaba Risikat RN175655 Adrienne Mims, MD 33152 8802 477 Windsor St, Suite 309 Atlanta, GA 30312 7/1/2013 Wednesday, June 27, 2018 Page 2 of 410 APRN Name RN# Delgating Physicia PHY# Protocol # Protcol Address Terminated Adeyemi, Afusat RN202394 Mehmood Mehdi, MD 57725 14765 367 Athens Hwy, Ste 1050 Loganville, Ga 30052 2/20/2016 Adeyemo, Oluwatoke Abidemi RN175909 Debra Houry, MD 50889 12805 49 Jesse Hill Dr SE, Emer Dept. Atlanta, GA 30303 8/25/2014 Adibe, Josephine Obiy RN111866 Hany Atallah, MD 52678 13869 80 Jessie Hill Dr. SE P.O. Box 26178 Atlanta, GA 30303 8/19/2015 Adjei, Vincentia Asantewah RN201559 Saied Murphy, MD 39187 13714 1350 Montreal Rd., Ste 210 Tucker, GA 30084 1/9/2015 Adjei, Vincentia Asantewah RN201559 Kobina Wilmot, MD 68577 21034 2551 Roswell Rd. ste. 415 Marietta, GA 30062 8/2/2017 Adkison, Tasha Michele Cobb RN147420 Theron Thompson, MD 51772 9555 1825 Martha Berry Blvd Rome, GA 30165 7/1/2011 Adkison, Tasha Michele Cobb RN147420 Todd Robinson, MD 40773 8747 14 Cherokee Rd Cedartown, GA 30125 1/21/2012 Affleck, Susan M. RN099501 Ashley C. Davis, MD 58161 11467 5555 Whittlesey Blvd, #L-1 Columbus, GA 31909 6/6/2014 Afolabi, Wuraola B. RN210974 Deronda Brown, MD 50079 17645 106 E. Broad St. Savannah, GA 31410 6/11/2016 Agbede, Olubunmi Omolola RN205174 Francis Gonzalez, MD 57810 12794 677 Church St Marietta, GA 30060 5/11/2015 Agnew, Greta M Gilson RN054192 Alan Wang, MD 48017 15003 1117 Perimeter Pkwy West, Ste N500 Atlanta, GA 30388 2/20/2015 Agomessou, Ablavi RN214710 Nancy R. Watson, MD 42766 40100 633 Falls Road (P O Box 1129) Toccoa, GA 30577 5/22/2018 Agyepong, Dorothy Dee RN109364 Apal L. Hartman, MD 50887 17559 2000 10th Ave, Ste 400 Columbus, GA 31901 2/28/2018 Wednesday, June 27, 2018 Page 3 of 410 APRN Name RN# Delgating Physicia PHY# Protocol # Protcol Address Terminated Ailes, Lisa Renee RN243650 Charles Roman, DO 43757 15167 2737 Warm Springs Rd Columbus, GA 31904 6/6/2015 Akins, Scott RN231437 Sara Sambandham, MD 64964 16127 5673 Peachtree-Dunwoody Rd 5th floor Atlanta, GA 30342 1/8/2016 Akins, Katharine L Reeves RN081701 Willis McVay, MD 54833 25 501 East Long St Claxton, GA 30417 5/1/2014 Akins, Scott RN231437 Thomas Price, MD 53367 14649 5673 Peachtree Dunwoody Rd Atlanta, GA 30342 6/30/2015 Akpan, Inemienyu RN181184 Ault, Kevin MD 56403 10644 69 Jesse Hill Jr Dr., SE, Gyn/OB Dept, 4th floor Atlanta, GA 3030 12/13/2012 Alaka, Olushola RN165259 John Ogundipe, MD 39193 15890 2130 Anderson Mill Rd Austell, GA 30106 10/7/2015 Alamu, Ikeade Bello RN211052 Jonathan Rosenfiled, MD 74345 18862 3240 South Cobb Dr. Smyrna, GA 30082 12/4/2016 Albano, Jessica Lyn RN159786 Jeff Donohue, MD 46540 8248 3755 Sixes Road, Suite 202 Canton, GA 30144 3/24/2009 Albritton, Amber Laine RN174507 James Palazzolo, MD 37637 13022 804 13th Ave Albany, GA 31707 6/10/2016 Alday, Vicky Lynn Whittington RN061053 Tom Vann Willis, Jr., MD 10695 27 1131 Chapel Crossing Rd, Bldg 252 Glynco, GA 31524 11/1/2015 Alderman, Troy RN212358 Gutierrez, Raymond MD 57983 10892 701 N. Slappey Blvd Albany, GA 31701 3/7/2018 Alexander, Cassie Rae RN140383 Colville Ferdinand, MD 53439 12189 1120 15th Street, BA-4416 Augusta, GA 30912 3/31/2017 Alexis-Destin, Bernadette RN198438 Anne Grant, MD 70244 15323 5294 Adams St Covington, GA 30014 9/30/2016 Wednesday, June 27, 2018 Page 4 of 410 APRN Name RN# Delgating Physicia PHY# Protocol # Protcol Address Terminated Alexis-Destin, Bernadette RN198438 Willard, Kim MD 29123 10891 101 Commerce Blvd, Ste l Barnesville, GA 30204 10/1/2014 Alexis-Destin, Bernadette RN198438 Gwathney, Miriam DO 63343 10101 101 Commerce Place, Suite 1 Barnesville, GA 30204 3/30/2012 Aliffi, Kathy Jeanette Castille RN089463 Nicole Nunga, MD 61580 12338 600 Parkway North Newnan, GA 30265 9/18/2013 Allen, Carrie Boswell RN201380 Edgar Melendez, MD 41167 18500 9280 Hwy. 5 ste. A Douglasville, GA 30134 8/15/2016 Allen, Vivian Lynn RN134633 Kevin Fussell, MD 67298 17344 2500 Starling St, Ste 504 Brunswick, GA 31520 7/5/2016 Allen, Michelle Marie RN184598 Guilda Saint Fleur, MD 69627 15834 774 GA Hwy 96 Bonaire, GA 31005 6/24/2016 Allen, Carrie Boswell RN201380 Elizabeth Norwood, MD 46192 12926 2739 Felton Dr East Point, GA 30344 11/16/2015 Allen, Renai A RN222518 David Asrael, MD 51291 12767 2988 Shallowford Rd Marietta, GA 30066 3/13/2015 Allen, Renai A RN222518 Wallace Duncan, MD 41109 12419 2988 Shallowford Rd Marietta, GA 30066-3033 3/13/2015 Allen, Jane Nix RN072414 Terry Hansen, MD 47330 48 184-A Professional Dr Baldwin, GA 30511 7/30/2014 Allen, Sonya A RN077192 Song Na, MD 38059 11761 4995 Lanier Islands Pkwy, Suite A Buford, GA 30518 4/17/2015 Allen, Sonya M. RN077192 Meena J. Shah, MD 21464 11499 475 Philip Blvd, Ste 100 Lawrenceville, GA 30045 5/10/2013 Allen, Sonya M. RN077192 Raja Ram, MD 39822 9865 475 Phillip Blvd. Lawrenceville, GA 30045 12/1/2012 Wednesday, June 27, 2018 Page 5 of 410 APRN Name RN# Delgating Physicia PHY# Protocol # Protcol Address Terminated Allen, Sonya M. RN077192 Thomas Karisny, MD 50029 7724 170 Hospital Circle, Suite A Blairsville, GA 30512 8/18/2010 Allen, Bryan Patrick RN162545 Richard Morse, MD 42094 8330 2122 Manchester Expressway Columbus, GA 31904 5/23/2014 Allen, Vivian Lynn RN134633 Herman Levy, MD 34010 7821 2500 Starling St, Suite 504 Brunswick, GA 31520 8/10/2016 Allen, Deborah C. RN190740 Rani Reddy, MD 34450 8201 106 Briarwood Road Statesboro, GA 30458 4/1/2009 Allen, Bryan Patrick RN162545 Zulfiquar Bhatti, MD 48482 8101 1906 Warm Springs Road Columbus, GA 31909 9/9/2008 Allen, Aurelia RN121276 Husham Peter Mishu, MD 40740 39 285 Boulevard, NE Ste #345 Atlanta, GA 30312 8/21/2009 Alleyne, Montrese Pitmon RN155438 Valens Plummer, MD 49496 12539 595 Piedmont Ave, Suite 100 Atlanta, GA 30308 8/30/2014 Allicock, Alisa Natasha RN198722 Kabir Das, MD 62867 12255 231 Graefe St Griffin, GA 30224 9/30/2014 Allmond, Lynn Marie Downard RN111386 Daron Ferris, MD 31593 55 1423 Harper St Augusta, GA 30912 8/15/2015 Alston, Marion RN087708 Trent Schueneman, MD 51731 15925 2927 Demere Rd Saint Simons Island, GA 31522 6/30/2016 Altringer, Joanne May Gensel RN131761 Michelle Perry, MD 53017 14084 2060 Dan Proctor Dr., Ste 1800 St Marys, GA 31558 8/31/2017 Altringer, Joanne May Gensel RN131761 Takacs-diLoranzo, Eva MD 48859 5027 202 Lakeshore Drive, Ste A St. Marys, GA 31558 9/1/2014 Amankwah, Pearl Opokua RN195776 Amanda Davis, MD 50152 12531 1133 Eagles Landing Pkwy Stockbridge, GA 30281 4/1/2014 Wednesday, June 27, 2018 Page 6 of 410 APRN Name RN# Delgating Physicia PHY# Protocol # Protcol Address Terminated Amazon-Leece, Jody Lee RN096082 Venkatappa R.
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