MEDICARE: GEORGINA RAMSEY NURSE PRACTITIONER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5006019	NC

General Provider Information

NPI Number	:	1952648677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGINA RAMSEY NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	520 N DEKALB ST
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-4188
Country	:	US
Telephone Number	:	704-484-8001
Fax Number	:	704-484-2485

Provider Business Practice Location Address
First Line	:	520 N DEKALB ST
Second Line	:
City	:	SHELBY
State	:	NC
Zip	:	28150-4188
Country	:	US
Telephone Number	:	704-484-8001
Fax Number	:	704-484-2485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	04/10/2013

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