Individual
MRS. KACIE MIRANDA PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(706) 509-5000
Mailing address
304 TURNER MCCALL BLVD SW, ROME, GA 30165-5621
(706) 509-5000
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN230749
GA
363LF0000X
Family Nurse Practitioner
Primary
RN230749
GA
Other
Enumeration date
12/02/2016
Last updated
04/12/2017
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