Unknown Individual – Family Nurse Practitioner, NPI 1629380019
Family Nurse Practitioner
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
60 LAKE SHORE DR
THOMASVILLE, GA 317570990
Phone: (901) 517-0421
Type: Mailing
3015 VETERANS PKWY S
MOULTRIE, GA 317886705
Phone: (229) 985-4815
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 31757)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | GA | 90833 | Psychotherapy, 30 minutes with patient and/or family member | 294 | 123 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | GA | |
| - | GA | |
| Nurse Practitioner | GA | |
| Physician Assistant | GA | |
| Physician Assistant | GA | |
| P S Y C H I A T R Y | GA | |
| Physician Assistant | GA | |
| P S Y C H I A T R Y | GA | |
| Nurse Practitioner | GA | |
| Nurse Practitioner | GA |
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