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General NPI Number Information
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NPI Number | 1255991667
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Entity Type | Organization
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Legal Business Name | HEALTH ADVOCATE PORTABLE PRACTITIONER TO YOU LLC
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Dates
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Enumeration Date | 06/18/2019
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Last Update Date | 06/19/2019
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Provider Practice Location Address
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Address Line | 1365 OLD MILL RD
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City | CORNELIA
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State | GA
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Zip | 30531-4863
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Country | US
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Telephone | 770-789-7927
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Fax | 706-778-7285
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Provider Business Mailing Address
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Address Line | 1365 OLD MILL RD
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City | CORNELIA
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State | GA
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Zip | 30531-4863
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Country | US
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Telephone | 770-789-7927
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Fax | 706-778-7285
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Authorized Official
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Title or Position | OWNER
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Name | GINGER SWILLEY
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Credential | FNP-C
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Telephone | 770-789-7927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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