Provider Demographics
NPI:1255991667
Name:HEALTH ADVOCATE PORTABLE PRACTITIONER TO YOU LLC
Entity type:Organization
Organization Name:HEALTH ADVOCATE PORTABLE PRACTITIONER TO YOU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:SWILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:770-789-7927
Mailing Address - Street 1:1365 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-4863
Mailing Address - Country:US
Mailing Address - Phone:770-789-7927
Mailing Address - Fax:706-778-7285
Practice Address - Street 1:1365 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:CORNELIA
Practice Address - State:GA
Practice Address - Zip Code:30531-4863
Practice Address - Country:US
Practice Address - Phone:770-789-7927
Practice Address - Fax:706-778-7285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty