=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770932055
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALMA GARRETT N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2016
-----------------------------------------------------
Last Update Date | 06/08/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 450 CRESCENT DR
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30501-5079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-531-6083
-----------------------------------------------------
Fax | 770-531-4587
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 450 CRESCENT DR
-----------------------------------------------------
City | GAINESVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30501-5079
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-531-6083
-----------------------------------------------------
Fax | 770-531-4587
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN069188
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------