MEDICARE: PATRICIA F DUNCAN RN

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	261QA0600X	Adult Day Care Clinic/Center	ADC000177	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1215519459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA F DUNCAN RN

Provider Business Mailing Address
First Line	:	3780 NAPIER AVE
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31204-2753
Country	:	US
Telephone Number	:	478-718-7331
Fax Number	:	478-254-9736

Provider Business Practice Location Address
First Line	:	3780 NAPIER AVE
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31204-2753
Country	:	US
Telephone Number	:	478-718-7331
Fax Number	:	478-254-9736

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2021
Last Update Date	:	04/27/2021

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