Aycock, Carol Jane

Aycock, Carol Jane is an individual health care provider with primary practice located at 3131 S Main St , Moultrie GA 31768-6925. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Aycock, Carol Jane can be contacted via phone (229) 891-9131.

Contact Information

Primary practice address
3131 S Main St Moultrie GA 31768-6925
Phone: (229) 891-9131
Fax: (229) 891-9079
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R032218 Georgia

Profile Details

NPI number 1750316360
LBN Legal business name Aycock, Carol Jane
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2006
Last updated Nov 26th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750316360 NPPES
Georgia MEDICAID 000490476B
Georgia MEDICAID 000490476D
Georgia Other R032218
Georgia MEDICAID 00490476B

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