APRN and Delegating Physician - Active Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • April 18th, 2017
APRN Name RN# Delgating Physician PHY# Protocol # Protocol Address Effective Aaron, Stephanie RN116808 David Dean, MD 64808 9854 95 Collier Rd, Suite 5015 Atlanta, GA 30309 8/5/2011 Abbey, Ophelia RN215132 Sherica Rosser, MD 61157 15665 3459 Holcomb Bridge Rd, Ste 100 Norcross, GA 30092 6/4/2015 Abbey, Ophelia Alice RN215132 Melinda Willingham, MD 45669 13872 4112 E. Ponce De Leon Ave. Clarkston, GA 30021 9/11/2014 Abdullahi, Antoinette RN236531 Freeman Montaque, MD 28123 13606 896 Highway East McDonough, GA 30252 8/7/2014 Abebe, Mahlet M. RN221110 Jayesh Naik, MD 33253 20253 11111 Houze Rd., Ste 225 Roswell, GA 30076 3/9/2017 Abera, Abebe Fentaw RN207642 Elisabeth Barclay, MD 56406 19185 250 Georgia Avenue SE ste. 206 Atlanta, GA 30312 12/1/2016 Abernathy, Taylor M RN205283 Santanu Das, MD 42560 13871 1049 N. Houston Rd. Warner Robins, GA 31093 9/11/2014 Abernathy, Pamela RN107241 Dark, Jennifer MD 66016 10682 1012 Burleyson Road Dalton, GA 30710 5/4/2012 Abernat
APRN and Delegating Physician - Active Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • February 10th, 2017
APRN Name RN# Delgating Physician PHY# Protocol # Protocol Address Effective Aaron, Stephanie RN116808 David Dean, MD 64808 9854 95 Collier Rd, Suite 5015 Atlanta, GA 30309 8/5/2011 Abbey, Ophelia RN215132 Sherica Rosser, MD 61157 15665 3459 Holcomb Bridge Rd, Ste 100 Norcross, GA 30092 6/4/2015 Abbey, Ophelia Alice RN215132 Melinda Willingham, MD 45669 13872 4112 E. Ponce De Leon Ave. Clarkston, GA 30021 9/11/2014 Abdullahi, Antoinette RN236531 Freeman Montaque, MD 28123 13606 896 Highway East McDonough, GA 30252 8/7/2014 Abera, Abebe Fentaw RN207642 Elisabeth Barclay, MD 56406 19185 250 Georgia Avenue SE ste. 206 Atlanta, GA 30312 12/1/2016 Abernathy, Taylor M RN205283 Santanu Das, MD 42560 13871 1049 N. Houston Rd. Warner Robins, GA 31093 9/11/2014 Abernathy, Deborah RN079832 Schaefer, Timothy MD 47524 10688 1700 Hospital South Drive, Ste 500 Austell, GA 30106 5/4/2012 Abernathy, Pamela RN107241 Dark, Jennifer MD 66016 10682 1012 Burleyson Road Dalt
NURSE PROTOCOL AGREEMENTNurse Protocol Agreement • September 2nd, 2021 • Georgia
Pursuant to O.C.G.A. Section 43-34-25(g.1), a physician at a location that maintains evidence-based clinical practice guidelines and is accredited by an accrediting body approved by the Board such as Joint Commission may enter into a nurse protocol agreement with not more than eight advanced registered nurses at any one time and supervise not more than four advanced registered nurses.
APRN and Delegating Physician - Active Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • March 19th, 2015
Aaron, Stephanie RN116808 David Dean, MD 64808 9854 95 Collier Rd, Suite 5015 Atlanta, GA 30309 8/5/2011 Abbey, Ophelia Alice RN215132 Melinda Willingham, MD 45669 13872 4112 E. Ponce De Leon Ave. Clarkston, GA 30021 9/11/2014 Abdullahi, Antoinette RN236531 Freeman Montaque, MD 28123 13606 896 Highway East McDonough, GA 30252 8/7/2014 Abernathy, Taylor M RN205283 Santanu Das, MD 42560 13871 1049 N. Houston Rd. Warner Robins, GA 31093 9/11/2014 Abernathy, Deborah RN079832 Schaefer, Timothy MD 47524 10688 1700 Hospital South Drive, Ste 500 Austell, GA 30106 5/4/2012 Abernathy, Pamela RN107241 Dark, Jennifer MD 66016 10682 1012 Burleyson Road Dalton, GA 30710 5/4/2012 Abon, Moradeke RN141176 Albert Anderson, MD 58136 11082 341 Ponce deLeon Ave. Atlanta, GA 30308 10/5/2012 Abraham, Linda M. RN178502 Jonathan Ehrlich, MD 15580 12325 993‐D Johnson Ferry Rd, Suite 360 Atlanta, GA 30342 10/10/2013 Abraham, Rennie Juanillo RN204958 Josephine Lopez, MD 4412
NURSE PROTOCOL AGREEMENTNurse Protocol Agreement • March 28th, 2018 • Georgia
The name of the APRN under this Agreement is . The APRN is a registered professional nurse licensed by the Georgia Board of Nursing and recognized by said Board as a nurse practitioner.
APRN and Delegating Physician - Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • September 21st, 2012
APRN Nam RN# Physician License# Address Date Date Fowlkes, Rebecca J. RN210612 John Chung, MD 41532 1107 Memorial Dr., Ste 201 Dalton GA 30720 9/13/2012 Rainey, Tiffany RN176596 Mark Hancock, MD 67750 163 Hospital Dr. Toccoa GA 30577 9/13/2012 Childress, Irene M. RN185501 Edward J. Kruse, DO 58055 1120 15th Street Augusta GA 30912 9/13/2012 Patton, David RN164071 RN164071 Bhumiben S. Purohit MD 58812 3600 Dallas Hwy, SW Marietta GA 30064 9/13/2012 Hall, Adriana Sanchez RN199078 Allan Dias, MD 65759 1100 Lake Hearn Dr, Suite 450 Atlanta GA 30342 9/13/2012 Phillips, Nancy Elanore RN162571 RN162571 Geoffrey Deutsch, MD 45061 100 Mimosa Dr. Thomasville GA 31792 9/13/2012 Cueto, Jonathan 203087 Ashok Kancharla, MD 48250 132 Franklin Spring St. Royston GA 30662 9/13/2012 Stewart, Merry Ann RN205580 205580 Lee Ann Merchen MD 60009 1447 Harper St. Augusta GA 30912 9/13/2012 Dawkins, Laneisha Ann RN162457 Eva Beaulieu, MD 66254 3600 Dallas Hwy SW Marietta GA 30064 9/13/2012
NURSE PROTOCOL AGREEMENTNurse Protocol Agreement • December 29th, 2009 • Georgia
Information regarding APRN: The APRN (Advanced Practice Registered Nurse) under this Agreement is . The APRN is a registered professional nurse licensed by the Georgia Board of Nursing and recognized by said Board as a nurse practitioner.
ADVANCED PRACTICE REGISTERED NURSE (APRN) NURSE PROTOCOL AGREEMENT TERMINATION NOTIFICATION FORMNurse Protocol Agreement • August 15th, 2018
This form should be completed ONLY if the DELEGATING PHYSICIAN is no longer DELEGATING PRESCRIPTIVE AUTHORITY to the APRN.
APRN and Delegating Physician - Active Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • August 27th, 2020
APRN Name RN# Delegating Physicia PHY# Protocol # Protcol Address Effective RN264080 52733 7/9/2020 49199 3/5/2020 Abajobir, Jaleny RN231657 Sophia Goodridge 82831 51126 2500 Hospital Blvd, Suite 290 Marietta, GA 30060 4/2/2020 Abajobir, Jaleny T. RN231657 Justin M. Watson, MD 69665 42945 55 Whither Street (Suite 250) Marietta, GA 30060 10/4/2018 Abbasi, Johnna RN202374 Jose Justiniano-Ayala 46773 44686 118 E Girard Ave Cedartown, Ga 30752 3/7/2019 Abbey, Ophelia RN215132 Tyshantra Coleman 63182 49219 2600 Martin Luther King Jr. Dirve SW, Suite 100 Atlanta, GA 3/5/2020 Abbey, Ophelia RN215132 Sherica Rosser, MD 61157 15665 3459 Holcomb Bridge Rd, Ste 100 Norcross, GA 30092 6/4/2015 Abdullahi, Antoinette RN236531 Freeman Montaque, MD 28123 13606 896 Highway East McDonough, GA 30252 8/7/2014 Abel, Christine Elizabeth RN219637 Titus A. Taube, MD 25296 42893 200 South Houston Lake Road (Suite B) Warner Robins, GA 3 10/4/2018 Abel, Janinne Marie RN243427 William Little, MD
ContractNurse Protocol Agreement • August 21st, 2017
ADVANCED PRACTICE REGISTERED NURSE (APRN) NURSE PROTOCOL AGREEMENT TERMINATION NOTIFICATION FORMNurse Protocol Agreement • December 29th, 2009
360-32-.05 (5) A delegating physician shall notify the Georgia Composite Medical Board within ten (10) working days of the date of termination of a nurse protocol agreement with the delegating physician and APRN.
Aprn Nurse Protocol AgreementNurse Protocol Agreement • July 28th, 2021
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Georgia Composite Medical BoardNurse Protocol Agreement • December 15th, 2020
NURSE PROTOCOL AGREEMENTNurse Protocol Agreement • October 30th, 2023 • Georgia
Pursuant to O.C.G.A. Section 43-34-25(g.1), a physician at a location that maintains evidence-based clinical practice guidelines and is accredited by an accrediting body approved by the Board such as Joint Commission may enter into a nurse protocol agreement with not more than eight advanced registered nurses at any one time and supervise not more than four advanced registered nurses.
Georgia Nurse Protocol AgreementNurse Protocol Agreement • August 25th, 2022
This state allows nurse practitioners prescriptive authority for drugs falling into schedule II. Victims of georgia is also confirm whether you respond to georgia nurse protocol agreement in conformance with or and supplement this. Citation Ga Code Ann 43-34-25b Nurse protocol agreement means a written document mutually agreed upon and signed by an advanced practice. Which arranges healthcare purchases for hospitals nursing homes and. The nurse midwives focus on each state regarding safe mechanism for those bills for an alleged acts to issues. Can see this day will help Ä•ecause they encourage a protocol agreement. Prior to prescribing, NPs must obtain a certificate from the department. In georgia department shall execute the agreement shall develop a np must contain explicit or classes, cancer screening of the subject to the report, parole and important. Georgia Department of Community Health, Division of Medicaid, Telemedicine Guidance, pg. If a doctor has APRNs, that doctor may have
APRN and Delegating Physician - Active Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • March 22nd, 2017
APRN Name RN# Delgating Physician PHY# Protocol # Protocol Address Effective Aaron, Stephanie RN116808 David Dean, MD 64808 9854 95 Collier Rd, Suite 5015 Atlanta, GA 30309 8/5/2011 Abbey, Ophelia RN215132 Sherica Rosser, MD 61157 15665 3459 Holcomb Bridge Rd, Ste 100 Norcross, GA 30092 6/4/2015 Abbey, Ophelia Alice RN215132 Melinda Willingham, MD 45669 13872 4112 E. Ponce De Leon Ave. Clarkston, GA 30021 9/11/2014 Abdullahi, Antoinette RN236531 Freeman Montaque, MD 28123 13606 896 Highway East McDonough, GA 30252 8/7/2014 Abera, Abebe Fentaw RN207642 Elisabeth Barclay, MD 56406 19185 250 Georgia Avenue SE ste. 206 Atlanta, GA 30312 12/1/2016 Abernathy, Taylor M RN205283 Santanu Das, MD 42560 13871 1049 N. Houston Rd. Warner Robins, GA 31093 9/11/2014 Abernathy, Pamela RN107241 Dark, Jennifer MD 66016 10682 1012 Burleyson Road Dalton, GA 30710 5/4/2012 Abernathy, Deborah RN079832 Schaefer, Timothy MD 47524 10688 1700 Hospital South Drive, Ste 500 Auste
APRN and Delegating Physician - Active Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • December 13th, 2019
APRN Name RN# Delegating Physicia PHY# Protocol # Protcol Address Effective Abajobir, Jaleny T. RN231657 Justin M. Watson, MD 69665 42945 55 Whither Street (Suite 250) Marietta, GA 30060 10/4/2018 Abbasi, Johnna RN202374 Jose Justiniano-Ayala 46773 44686 118 E Girard Ave Cedartown, Ga 30752 3/7/2019 Abbey, Ophelia RN215132 Sherica Rosser, MD 61157 15665 3459 Holcomb Bridge Rd, Ste 100 Norcross, GA 30092 6/4/2015 Abdullahi, Antoinette RN236531 Freeman Montaque, MD 28123 13606 896 Highway East McDonough, GA 30252 8/7/2014 Abebe, Mahlet RN221110 Karl Mihalvotis, MD 11776 20770 4015 South Cobb Drive Smyrna, GA 30080 6/9/2017 Abel, Christine Elizabeth RN219637 Titus A. Taube, MD 25296 42893 200 South Houston Lake Road (Suite B) Warner Robins, GA 3 10/4/2018 Abel, Janinne Marie RN243427 William Little, MD 24288 20722 104 Moore Street- Murdy Hall Oxford, GA 30054 7/13/2017 Abera, Abebe, F RN207642 Abdul H. Syed, MD 60330 40599 1670 Clairmont Rd. Decatur, GA 3
Approved Nurse Protocol Agreement GeorgiaNurse Protocol Agreement • February 3rd, 2021
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Terminated Nurse Protocol AgreementsNurse Protocol Agreement • August 1st, 2017
Aaron, Stephanie RN116808 Sanjay Lall, MD 57878 2 95 Collier Rd, Suite 5015 Atlanta GA 30309-1721 7/1/2011 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 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 RN178502 Hodges, Sharon MD 40759 10470 1372 Wellbrook Circle Conyers GA 30012 3/30/2012 Abraham, Linda M. RN178502 Phillip Bannister, MD 16503 5019 603-A Old Norcross Rd Lawrenceville GA 30045 10/1/2010 Abraham, Linda RN178502 Lynette Stewart, MD 39681 11113 3660 Flat Shoals Rd., Ste 180 Decatur GA 30034 4/16/2013 Abramson, Car
ADVANCED PRACTICE REGISTERED NURSE (APRN) NURSE PROTOCOL AGREEMENTNurse Protocol Agreement • June 12th, 2014
This form should be completed ONLY if the DELEGATING PHYSICIAN is no longer DELEGATING PRESCRIPTIVE AUTHORITY to the APRN.
APRN and Delegating Physician - Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • March 17th, 2013
Atlanta GA 30309 Atlanta GA 30309-1721 Dalton GA 30710 Austell GA 30106 Ellijay GA 30539 Atlanta GA 30308 Athens GA 3 Decatur GA 30034 Conyers GA 30012 Conyers GA 30012 Lawrenceville GA 30045 Atlanta GA 30342 Blairsville GA 30512 Gainesville GA 30501 Waycross GA 31501 Atlanta GA 30322 Albany GA 31701 Gainesville GA 30501 Atlanta GA 30309 Athens GA 30606 Gainesville GA 30501 Columbus GA 31909 Atlanta GA 30303
APRN and Delegating Physician - Reviewed Nurse Protocol AgreementsNurse Protocol Agreement • July 24th, 2014
Aaron, Stephanie RN116808 David Dean, MD Aaron, Stephanie RN116808 Sanjay Lall, MD Abernathy, Deborah RN079832 Schaefer, Timothy MD Abernathy, Pamela RN107241 Dark, Jennifer MD Abernathy, Kari Elizabeth RN154956 Jaime Burkle, MD Abon, Moradeke RN141176 Albert Anderson, MD Abraham, Linda M. RN178502 Jonathan Ehrlich, MD Abraham, Rennie Juanillo RN204958 Josephine Lopez, MD Abraham, Linda RN178502 Lynette Stewart, MD Abraham, Linda RN178502 Hodges, Sharon MD Abraham, Linda M. RN178502 Mohamad El‐Attar, MD Abraham, Linda M. RN178502 Phillip Bannister, MD Abramson, Cara Rothfield RN108696 Daniel Dubovsky, MD Abramson, Cara Michelle Rothfi RN108696 Thomas Seay, MD Acree, Lisa Pinkard RN126710 Melissa Dillmon, MD Acree, Lisa Pinkard RN126710 William Whaley, MD Acton, Patricia RN124420 Winston, Alan Daniel MD Adams, Holly Scott RN176923 Paul Guichard, DO Adams, Angela D. RN158173 Asit K. Jha, MD Adams, Jewel Ann RN079253 Donald Davis, MD
