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NPI Code Detail

MEDICARE: MRS. MARISA ELISE - GUERETTE CHORNEY FNP-BC

MEDICARE: MRS. MARISA ELISE - GUERETTE CHORNEY FNP-BC
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 Practitioner0024173184VA

General Provider Information

NPI Number : 1558727925
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARISA ELISE - GUERETTE CHORNEY FNP-BC
Provider Business Mailing Address
First Line : PO BOX 1705
Second Line :
City : AUGUSTA
State : GA
Zip : 30903-1705
Country : US
Telephone Number : 706-854-6008
Fax Number : 706-774-7230
Provider Business Practice Location Address
First Line : 3486 PEACH ORCHARD RD STE 200
Second Line :
City : AUGUSTA
State : GA
Zip : 30906-5215
Country : US
Telephone Number : 706-828-8049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2016
Last Update Date : 03/11/2021

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Directions to “ MRS. MARISA ELISE - GUERETTE CHORNEY FNP-BC” Practice Location

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