MEDICARE: ABSOLUTE MEDICAL STAFFING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner
2	163WG0000X	General Practice Registered Nurse

General Provider Information

NPI Number	:	1093187809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABSOLUTE MEDICAL STAFFING

Provider Business Mailing Address
First Line	:	500 LANIER AVE W STE 908
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7641
Country	:	US
Telephone Number	:	678-281-5523
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 LANIER AVE W STE 908
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7641
Country	:	US
Telephone Number	:	678-281-5523
Fax Number	:

Authorized Official
Title or Position	:	MEMBER/MANAGER
Name	:	SHERRA JOHNSON
Credential	:
Telephone Number	:	678-281-5523

Provider Enumeration Date	:	10/20/2015
Last Update Date	:	10/20/2015

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Directions to “ABSOLUTE MEDICAL STAFFING ” Practice Location

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