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General NPI Number Information
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NPI Number | 1770012015
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Entity Type | Individual
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Provider Name | BETSY JANICE COLQUITT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 11/15/2017
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Provider Practice Location Address
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Address Line | 675 HAMILTON ST
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City | SPARTA
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State | GA
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Zip | 31087-1837
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Country | US
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Telephone | 706-444-5242
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Fax | 706-444-7302
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Provider Business Mailing Address
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Address Line | 279 NAPIER RD
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City | EATONTON
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State | GA
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Zip | 31024-6832
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Country | US
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Telephone | 478-968-7776
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Fax |
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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 | RN084987
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License Number State | GA
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