Healthcare Provider Details

I. General information

NPI: 1992391346
Provider Name (Legal Business Name): VINCENT JOHN ACUNTO RN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 OLD HIGHWAY 5
BLUE RIDGE GA
30513-6248
US

IV. Provider business mailing address

212 ASTER LN
MORGANTON GA
30560-3249
US

V. Phone/Fax

Practice location:
  • Phone: 239-285-1788
  • Fax:
Mailing address:
  • Phone: 239-285-1788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN244849
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN244849
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: