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General NPI Number Information
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NPI Number | 1760643761
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Entity Type | Organization
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Legal Business Name | HEALTH CONNECTION INC
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 657 ATHENS ST
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City | JEFFERSON
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State | GA
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Zip | 30549-1474
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Country | US
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Telephone | 706-367-7302
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Fax |
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Provider Business Mailing Address
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Address Line | 657 ATHENS ST
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City | JEFFERSON
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State | GA
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Zip | 30549-1474
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Country | US
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Telephone | 706-367-7302
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANGELA HAYNES
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Credential |
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Telephone | 706-367-7302
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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 | R100015
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License Number State | GA
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