MEDICARE: ADVANCED PRACTICE NP SERVICES, LLC

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	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1194562058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PRACTICE NP SERVICES, LLC

Provider Business Mailing Address
First Line	:	515 N WESTOVER BLVD STE C5
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2145
Country	:	US
Telephone Number	:	229-449-0180
Fax Number	:	229-639-1043

Provider Business Practice Location Address
First Line	:	515 N WESTOVER BLVD STE C5
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31707-2145
Country	:	US
Telephone Number	:	229-449-0180
Fax Number	:	229-639-1043

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MARIA NELSON
Credential	:
Telephone Number	:	229-449-0180

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	07/09/2024

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