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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891973483 | NPPES |
| Georgia | MEDICAID | 220573126A |
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