Parham, Loretta Ann

Parham, Loretta Ann is an individual health care provider with primary practice located at 1061 Harmon Ave Ste 1D03, Fort Stewart GA 31314-5641. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Parham, Loretta Ann can be contacted via phone (912) 507-4492.

Contact Information

Primary practice address
1061 Harmon Ave Ste 1D03 Fort Stewart GA 31314-5641
Phone: (912) 507-4492
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 004410 Georgia

Profile Details

NPI number 1104874981
LBN Legal business name Parham, Loretta Ann
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Aug 3rd, 2012 - about 12 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 1104874981 NPPES
Georgia MEDICAID 264954116B
Georgia MEDICAID 264954116A

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