Provider Demographics
NPI:1134392913
Name:MARAT, PATTI LORRI (RN MSN APRN NP-C)
Entity type:Individual
Prefix:MRS
First Name:PATTI
Middle Name:LORRI
Last Name:MARAT
Suffix:
Gender:F
Credentials:RN MSN APRN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 633
Mailing Address - Street 2:
Mailing Address - City:SANDERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31082-0633
Mailing Address - Country:US
Mailing Address - Phone:478-412-2105
Mailing Address - Fax:
Practice Address - Street 1:106 W 2ND AVE
Practice Address - Street 2:
Practice Address - City:SANDERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31082-9204
Practice Address - Country:US
Practice Address - Phone:478-412-2105
Practice Address - Fax:706-432-1620
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN129055 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA03182279HMedicaid