MEDICARE: MR. LONNIE PIATT 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	RN243145	GA

General Provider Information

NPI Number	:	1992230221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LONNIE PIATT FNP-BC

Provider Business Mailing Address
First Line	:	6351 BLANCHARD CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-3675
Country	:	US
Telephone Number	:	337-424-1947
Fax Number	:

Provider Business Practice Location Address
First Line	:	6351 BLANCHARD CT
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-3675
Country	:	US
Telephone Number	:	337-424-1947
Fax Number	:

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

Provider Enumeration Date	:	04/24/2017
Last Update Date	:	04/24/2017

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