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NPI Code Detail

MEDICARE: KIRA LASSITER PULLIAM CNM

MEDICARE: KIRA LASSITER PULLIAM CNM
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
1176B00000XMidwife0024167697VA
2176B00000XMidwifeRN167590GA

General Provider Information

NPI Number : 1609048727
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRA LASSITER PULLIAM CNM
Provider Business Mailing Address
First Line : 1900 10TH AVE
Second Line : STE 300
City : COLUMBUS
State : GA
Zip : 31901-3606
Country : US
Telephone Number : 757-390-6530
Fax Number :
Provider Business Practice Location Address
First Line : 1900 10TH AVE STE 300
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-3606
Country : US
Telephone Number : 706-341-3311
Fax Number : 706-341-3311
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2008
Last Update Date : 03/17/2018

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Directions to “ KIRA LASSITER PULLIAM CNM” Practice Location

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