Carruth, Celina Dawn
Carruth, Celina Dawn is an individual health care provider with primary practice located at 835 Austin Dr , Demorest GA 30535-4513. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Carruth, Celina Dawn can be contacted via phone (706) 754-8518.Contact Information
Primary practice address
835 Austin Dr
Demorest GA 30535-4513
Phone: (706) 754-8518
Fax: (706) 754-6238
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN102719 | Georgia |
Profile Details
| NPI number | 1942284120 |
|---|---|
| LBN Legal business name | Carruth, Celina Dawn |
| Credentials | Certified Family Nurse Practitioner (CFNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Sep 24th, 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 | 1942284120 | NPPES |
| Georgia | MEDICAID | 000933721A | |
| Georgia | Other | 01995452 | |
| Georgia | Other | 968444 | |
| Georgia | MEDICAID | 003145843A |
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