MEDICARE: MRS. NATASHA GARRITSON 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
1	363LF0000X	Family Nurse Practitioner	RN224869	GA

General Provider Information

NPI Number	:	1861994113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATASHA GARRITSON FNP-BC

Provider Business Mailing Address
First Line	:	81 HEBRON CHURCH RD
Second Line	:
City	:	DACULA
State	:	GA
Zip	:	30019-2109
Country	:	US
Telephone Number	:	843-729-2742
Fax Number	:

Provider Business Practice Location Address
First Line	:	1238 FALLS RD
Second Line	:
City	:	TOCCOA
State	:	GA
Zip	:	30577-2407
Country	:	US
Telephone Number	:	706-886-6090
Fax Number	:	706-898-6091

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

Provider Enumeration Date	:	03/02/2018
Last Update Date	:	03/02/2018

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