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NPI Code Detail

MEDICARE: PATRICIA SIEFFERMAN NP-C

MEDICARE:   PATRICIA  SIEFFERMAN  NP-C
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
1363LF0000XFamily Nurse Practitioner27377GA
2363LF0000XFamily Nurse Practitioner17559SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093709453
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA SIEFFERMAN NP-C
Provider Business Mailing Address
First Line : 12192 AUGUSTA RD
Second Line : 12192 AUGUSTA ROAD
City : LAVONIA
State : GA
Zip : 30553-1209
Country : US
Telephone Number : 706-356-1072
Fax Number : 706-356-1457
Provider Business Practice Location Address
First Line : 901 W GREENWOOD ST
Second Line : SUITE 5
City : ABBEVILLE
State : SC
Zip : 29620-5717
Country : US
Telephone Number : 864-366-9938
Fax Number : 864-366-0818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 11/30/2011

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Directions to “ PATRICIA SIEFFERMAN NP-C” Practice Location

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