Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | APN17983RX | SC |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN232945 | GA |
NPI | 1043316417 |
---|---|
Provider Name | Ms. Patricia Fall |
First Address | Savannah, GA 31406-3639 |
Second Address | Savannah, GA 31406-3639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 09/01/2017 |