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NPI Code Detail

MEDICARE: COURTNEY O RAGAN FNP

MEDICARE:   COURTNEY O RAGAN  FNP
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
1363L00000XNurse PractitionerRN245285GA
2363LF0000XFamily Nurse PractitionerRN245285GA

General Provider Information

NPI Number : 1811402829
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY O RAGAN FNP
Provider Business Mailing Address
First Line : 125 CHURCH ST
Second Line :
City : VIDALIA
State : GA
Zip : 30474-4770
Country : US
Telephone Number : 912-538-8484
Fax Number :
Provider Business Practice Location Address
First Line : 125 CHURCH ST
Second Line :
City : VIDALIA
State : GA
Zip : 30474-4770
Country : US
Telephone Number : 912-538-8484
Fax Number : 912-538-8484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2017
Last Update Date : 05/05/2021

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Directions to “ COURTNEY O RAGAN FNP” Practice Location

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