Provider Demographics
NPI:1972664670
Name:ALTRINGER, JOANNE (CNM)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:ALTRINGER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 LAKESHORE DR STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-3809
Mailing Address - Country:US
Mailing Address - Phone:912-673-1771
Mailing Address - Fax:912-673-1811
Practice Address - Street 1:202 LAKESHORE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558
Practice Address - Country:US
Practice Address - Phone:912-673-1771
Practice Address - Fax:912-673-1811
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2009-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN131761367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000733466EMedicaid