Bacot, Eliza Johnson

Bacot, Eliza Johnson is an individual health care provider with primary practice located at 600 Celebrate Life Pkwy , Newnan GA 30265-8001. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine, which is considered as her primary health care specialty. Bacot, Eliza Johnson can be contacted via phone (678) 907-2999.

Contact Information

Primary practice address
600 Celebrate Life Pkwy Newnan GA 30265-8001
Phone: (678) 907-2999
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Critical Care Medicine 363LC0200X RN168366 Georgia

Profile Details

NPI number 1891973483
LBN Legal business name Bacot, Eliza Johnson
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2008
Last updated Nov 17th, 2014 - about 11 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 1891973483 NPPES
Georgia MEDICAID 220573126A

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