Fossett, Phyllis R

Fossett, Phyllis R is an individual health care provider with primary practice located at 380 Hospital Drive Suite 410, Macon GA 31217. 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. Fossett, Phyllis R can be contacted via phone (478) 746-5644.

Contact Information

Primary practice address
380 Hospital Drive Suite 410 Macon GA 31217
Phone: (478) 746-5644
Fax: (478) 745-4849
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN066808 Georgia

Profile Details

NPI number 1245207414
LBN Legal business name Fossett, Phyllis R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 7th, 2006
Last updated Jun 4th, 2013 - 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 1245207414 NPPES
Georgia MEDICAID 000582788D
Georgia MEDICAID 000582788F
Georgia MEDICAID 000582788E
Georgia Other 430032146
Georgia Other 430060612
Georgia Other 391026

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