Terminated Nurse Protocol Agreements

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Terminated Nurse Protocol Agreements Terminated Nurse Protocol Agreements APRN Name RN# Delgating Physician License# Protocol # Address Terminated Aaron, Stephanie RN116808 Sanjay Lall, MD 57878 2 95 Collier Rd, Suite 5015 Atlanta GA 30309-1721 7/1/2011 Abernathy, Kari Elizabeth RN154956 Jaime Burkle, MD 48881 9783 309 Highland Pkwy, Suite 201 Ellijay GA 30539 5/7/2012 Abon, Moradeke RN141176 Albert Anderson, MD 58136 11082 341 Ponce deLeon Ave. Atlanta GA 30308 8/24/2015 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 Abraham, Linda RN178502 Hodges, Sharon MD 40759 10470 1372 Wellbrook Circle Conyers GA 30012 3/30/2012 Abraham, Linda RN178502 Lynette Stewart, MD 39681 11113 3660 Flat Shoals Rd., Ste 180 Decatur GA 30034 4/16/2013 Abramson, Cara Michelle Rothfield 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 Acree, Lisa Pinkard RN126710 William Whaley, MD 11504 9 750 Deep South Farm Rd Blairsville GA 30512 9/25/2014 Acree, Lisa 126710 McCormick 25219 16688 501 Redmond Rd Rome GA 30165 12/11/2015 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 Adegbuji, Omoronke Olufunmilayo 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 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 Wednesday, January 13, 2016 Page 1 of 171 APRN Name RN# Delgating Physician License# Protocol # Address Terminated Adjei, Vincentia Asantewah RN201559 Saied Murphy, MD 39187 13714 1350 Montreal Rd., Ste 210 Tucker GA 30084 1/9/2015 Adkison, Tasha Michele Cobb RN147420 Todd Robinson, MD 40773 8747 14 Cherokee Rd Cedartown GA 30125 1/21/2012 Adkison, Tasha Michele Cobb RN147420 Theron Thompson, MD 51772 9555 1825 Martha Berry Blvd Rome GA 30165 7/1/2011 Affleck, Susan M. RN099501 Ashley C. Davis, MD 58161 11467 5555 Whittlesey Blvd, #L-1 Columbus GA 31909 6/6/2014 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 Ailes, Lisa Renee RN243650 Charles Roman, DO 43757 15167 2737 Warm Springs Rd Columbus GA 31904 6/6/2015 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, Atlanta GA 30303 12/13/2012 4th floor Alaka, Olushola RN165259 John Ogundipe, MD 39193 15890 2130 Anderson Mill Rd Austell GA 30106 10/7/2015 Albano, Jessica Lyn RN159786 Jeff Donohue, MD 46540 8248 3755 Sixes Road, Suite 202 Canton GA 30144 3/24/2009 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, Sonya M. RN077192 Raja Ram, MD 39822 9865 475 Phillip Blvd. Lawrenceville GA 30045 12/1/2012 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, Renai A RN222518 David Asrael, MD 51291 12767 2988 Shallowford Rd Marietta GA 30066 3/13/2015 Allen, Sonya M. RN077192 Thomas Karisny, MD 50029 7724 170 Hospital Circle, Suite A Blairsville GA 30512 8/18/2010 Wednesday, January 13, 2016 Page 2 of 171 APRN Name RN# Delgating Physician License# Protocol # Address Terminated Allen, Bryan Patrick RN162545 Richard Morse, MD 42094 8330 2122 Manchester Expressway Columbus GA 31904 5/23/2014 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 Allen, Renai A RN222518 Wallace Duncan, MD 41109 12419 2988 Shallowford Rd Marietta GA 30066-3033 3/13/2015 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 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 Amazon-Leece, Jody Lee RN096082 Venkatappa R. Rangaraj, MD 58633 11468 2795 Main St, West #27 Snellville GA 30078 8/15/2014 Amerson, Keri Lynn RN141829 Richard Ambrozic, MD 43851 9748 3321-B N. Valdosta Rd Valdosta GA 31602 8/22/2014 Amukamara, Ernest U RN201832 Jay Schlossberg, MD 19996 11791 5820 Old National HWY College Park GA 30349 7/10/2014 Amukamara, Ernest U RN201832 Mitzi Rubin, MD 49592 12081 3939 Roswell Rd, Suite 200 Marietta GA 30062 5/23/2013 Amukamara, Ernest U. RN201832 James Criner, MD 54179 8733 7530 Roswell Road Atlanta GA 30350 10/21/2010 Anaele, Caroline RN135346 Obiorah, Samuel MD 42379 9991 1009 3rd Avenue West Point GA 31833 4/9/2012 Anaele, Caroline Chika RN135346 Travan Jasper, MD 45506 14148 1762 Mars Hill Rd N W Acworth GA 30101-8091 12/4/2014 Anaele, Caroline RN135346 Louis, Okiki MD 47479 10893 1762 Mars Hill Rd NW Acworth GA 30101 11/8/2014 Anaele, Caroline Chika Obasi RN135346 Jada Moore-Ruffin, MD 57395 13339 2121 Fairburn Rd., Ste B Douglasville GA 30135 7/1/2015 Anders, Onitisha RN222372 Xiaofeng Zhong, MD 69466 15404 100 Goshen Rd Rincon GA 31326 9/21/2015 Anders, Onitisha Vondese RN222372 Toni Sylvester, MD 58933 15161 110 Goshen Rd. Rincon GA 31326 9/25/2015 Wednesday, January 13, 2016 Page 3 of 171 APRN Name RN# Delgating Physician License# Protocol # Address Terminated Anderson, Tabatha Peavy RN149791 James Greene, MD 32741 8206 590 Historic Hwy 441 North Demorest GA 30535 8/13/2013 Anderson, Christa RN129289 Fordham, Donald MD 44718 10538 865 Austin Drive, PO Box 308 Demorest GA 30535 1/15/2015 Anderson, Christina Elaine RN154861 Sallu Jabati, MD 58527 12897 3722 Woodruff Road Columbus GA 31906 2/18/2014 Anderson, Geraldine Jackson RN115669 Sima Dehghany, MD 62494 9709 216 Hospital Rd Cordele GA 31015 8/31/2011 Anderson, Christina Elaine RN154861 Edet Bassey, MD 44408 11829 1041 Talbotton Rd Columbus GA 31907 12/4/2013 Anderson, Sandra RN162692 Lionel Bryan, MD 22725 15039 1007 Mary St Waycross GA 31501 4/1/2015 RN162692 Anderson-Parris, Mary Ann RN122052 Muhammad Alam, MD 69167 12357 3015 Veterans Pkwy Moultrie GA 31788 1/24/2015 Andrews, Regina Lynn RN154122 Timothy Graves, MD 26859 8227 770 Walnut Street Macon GA 31201 5/3/2013 Andrews, Regina Lynn RN154122 Dorothy Stewart, MD 46565 8129 325-A North Cobb Street Milledgeville GA 31061 4/12/2008 Angstadt, Joanne Fitzgerald RN176262 Paul Bradley, MD 30016 7954 340 Eisenhower Dr, Suite 1200 Savannah GA 31406 11/6/2009 Aninwene, Joy Chizobam RN205267 Ephraim Ahanonu, MD 48749 9529 611 Monroe St Macon GA 31201 7/25/2012 Anom, Aileen Michelle RN113842 Christopher Stevens, MD 54515 8387 2990 Five Forks Trickum Rd SW Lawrenceville GA 30044 7/27/2009 Ansley, Diane RN046318 Blumer, John MD 53101 10077 3222A Shrine Road Brunswick GA 31520 1/5/2014 Anthony, Charmaine Simone RN183722 Robert Brown, MD 56269 8209 5455 Meridian Mark Rd, Suite 400 Atlanta GA 30342 7/17/2014 Antinoro, Gloria Taff Hicks RN091472 Charles Roman, DO 43757 9259 2737 Warm Springs Rd, Suite B Columbus GA 31904 9/24/2010 Anyanwu, Justina RN156181 Nagnur, Shreedhar MD 49192 10540 600 West Memorial Drive Dallas GA 30132 6/7/2013 Apke, Jennifer RN211693 Broadney, Michlene MD 55207 10185 1279 Hwy 54 West, Ste 220 Fayetteville GA 30214 6/30/2012 Appiah-Kubi, Mavis RN185422 Walter Smith, MD 37078 8415 3498 Walnut Ridge Atlanta GA 30349 8/25/2009 Appiah-Kubi, Mavis RN185422 Lawrence Powell, MD 38915 7977 4120 Austell Road SW Austell GA 30106 5/29/2009 Appiah-Kubi, Mavis RN185422 Phillip Nowlin, MD 36588 8916 4480 South Cobb Dr SE Smyrna GA 30080 7/31/2010 Wednesday, January 13, 2016 Page 4 of 171 APRN Name RN# Delgating Physician License# Protocol # Address Terminated Arabshahi, Farnaz RN151189 Isioma Okwumabua, MD 70256 13931 3003 Old Alabama Rd Alpharetta GA 30022 11/14/2014 Archer, Holly Lynn Hargrove RN124097 Richard Loyd, DO 37446 93 601 A Professional Dr.
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