Miclat, Cristine Palacios

Miclat, Cristine Palacios 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 / Adult Health, which is considered as her primary health care specialty. Miclat, Cristine Palacios can be contacted via phone (912) 435-6965.

Contact Information

Primary practice address
1061 Harmon Ave Ste 1D03 Fort Stewart GA 31314-5641
Phone: (912) 435-6965
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN135637 Georgia

Profile Details

NPI number 1649418310
LBN Legal business name Miclat, Cristine Palacios
Credentials APRN, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2009
Last updated Dec 27th, 2016 - about 10 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 1649418310 NPPES
Other 01299571 AMERIGROUP
MEDICAID 158532534B AMERIGROUP
Other P00714517 AMERIGROUP

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