PRESTIGE ADVANCED HEALTHCARE NPI 1942736160

NPI Information

NPI: 1942736160
Provider Name: PRESTIGE ADVANCED HEALTHCARE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
102 MAIN ST STE 204
LAGRANGE, GA
ZIP 30240
Phone: (706) 756-5317
Get Directions

PRESTIGE ADVANCED HEALTHCARE is a primary care clinic center in Lagrange, GA. PRESTIGE ADVANCED HEALTHCARE NPI is 1942736160. The provider is registered as an organization entity type.

The provider's business location address is:

102 MAIN ST STE 204
LAGRANGE, GA
ZIP 30240-225
Phone: (706) 756-5317
Fax: (844) 740-1379

The provider's authorized official is Cierra Nicole Williams .
The authorized official title is Nurse Practitioner and has the following contact phone number (470) 295-9981.

The enumeration date for this NPI number is 5/8/2017 and was last updated on 10/18/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	233631	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1730557752	OTHER	GEORGIA	NURSE PRACTITIONER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »