MEDICARE: MS. MONSHITA MCDONALD 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
1	363LC1500X	Community Health Nurse Practitioner	RN214566	GA

General Provider Information

NPI Number	:	1861006223
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONSHITA MCDONALD FNP

Provider Business Mailing Address
First Line	:	1523 SAN BERNARDINO WAY
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31601-2511
Country	:	US
Telephone Number	:	229-942-9618
Fax Number	:

Provider Business Practice Location Address
First Line	:	1523 SAN BERNARDINO WAY
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31601-2511
Country	:	US
Telephone Number	:	229-942-9618
Fax Number	:

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

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	11/27/2023

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