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General NPI Number Information
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NPI Number | 1518784206
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Entity Type | Organization
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Legal Business Name | GEORGIA WAR VETERANS HOME
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Dates
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Enumeration Date | 09/24/2024
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 2249 VINSON HWY SE
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-4807
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Country | US
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Telephone | 478-445-3234
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 S QUINCY ST STE 888
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City | ARLINGTON
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State | VA
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Zip | 22206-2233
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Country | US
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Telephone | 703-578-6030
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Fax |
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Authorized Official
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Title or Position | HEALTHCARE OPERATIONS MANAGER
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Name | CANDICE BURNSIDE
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Credential | APRN
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Telephone | 703-578-6030
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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 |
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License Number State |
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Taxonomy #2
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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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