Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Clinica Agave Clinic

Organization Family Nurse Practitioner · NPI 1407091705

Clinica Agave Clinic provides Family Nurse Practitioner services in Forest Park, Georgia. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

4434 Jonesboro Rd
Forest Park, GA 30297-4313 Not confirmed with CMS for 17 years — call before visiting
Phone: (404) 447-3444
Fax: (404) 377-3445
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X

Record details

NPI number1407091705
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Judith Chabot — Provider · (404) 447-3444
NPI enumeratedDecember 16, 2008
Last updated in NPPESDecember 16, 2008
Mailing address4434 Jonesboro Rd, Forest Park, GA 30297-4313

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