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General NPI Number Information
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NPI Number | 1376375568
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Entity Type | Individual
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Provider Name | KYLIE COTTON GANTT NP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2024
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 7 HOSPITAL PARK
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City | MOULTRIE
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State | GA
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Zip | 31768-6772
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Country | US
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Telephone | 229-985-4469
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Fax | 229-891-3526
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Provider Business Mailing Address
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Address Line | PO BOX 2876
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City | MOULTRIE
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State | GA
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Zip | 31776-2876
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Country | US
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Telephone | 229-502-9681
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Fax | 229-891-9130
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN298860
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License Number State | GA
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