Organization
FAMILY FIRST HEALTHCARE OF NORTHEAST GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE FORD NP (OFFICE MANAGER)
(706) 356-8181
Entity
Organization
Contact information
Practice address
11973 AUGUSTA RD, LAVONIA, GA 30553-1283
(706) 356-8181
(706) 356-8081
Mailing address
11973 AUGUSTA RD, LAVONIA, GA 30553-1283
(706) 356-8181
(706) 356-8081
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
RN144697NP
GA
363LC0200X
Critical Care Medicine Nurse Practitioner
RN144697NP
GA
363LF0000X
Family Nurse Practitioner
Primary
RN144697NP
GA
363LP2300X
Primary Care Nurse Practitioner
RN144697NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132982
—
SC
05
—
85001253G
—
GA
Enumeration date
02/24/2010
Last updated
06/28/2010
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