Provider Demographics
NPI:1255633368
Name:TRAWICK, ANNETTE T (RN)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:T
Last Name:TRAWICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:187 ROBERSON MILL RD NE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-4960
Mailing Address - Country:US
Mailing Address - Phone:478-456-4652
Mailing Address - Fax:478-414-1264
Practice Address - Street 1:187 ROBERSON MILL RD NE
Practice Address - Street 2:SUITE 110
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-4960
Practice Address - Country:US
Practice Address - Phone:478-456-4652
Practice Address - Fax:478-414-1264
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN068073163W00000X, 163WA0400X, 163WA2000X, 163WC1500X, 163WG0600X, 163WH0200X, 163WM0102X, 163WP0807X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult