Provider Demographics
NPI:1487200176
Name:MCGAHA, CHARLA REBECCA (NP)
Entity Type:Individual
Prefix:
First Name:CHARLA
Middle Name:REBECCA
Last Name:MCGAHA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 1ST ST STE 240
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-8308
Mailing Address - Country:US
Mailing Address - Phone:478-633-6900
Mailing Address - Fax:
Practice Address - Street 1:800 1ST ST STE 240
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-8308
Practice Address - Country:US
Practice Address - Phone:478-633-6900
Practice Address - Fax:478-633-2175
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN160137363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health