Healthcare Provider Details

I. General information

NPI: 1861994113
Provider Name (Legal Business Name): NATASHA GARRITSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 FALLS RD
TOCCOA GA
30577-2407
US

IV. Provider business mailing address

81 HEBRON CHURCH RD
DACULA GA
30019-2109
US

V. Phone/Fax

Practice location:
  • Phone: 706-886-6090
  • Fax: 706-898-6091
Mailing address:
  • Phone: 843-729-2742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN224869
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: