Provider Demographics
NPI:1801182100
Name:CUTIA, JAMES (NP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:CUTIA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:218 QUARTERMAN ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31501-3547
Mailing Address - Country:US
Mailing Address - Phone:912-287-0301
Mailing Address - Fax:912-287-1568
Practice Address - Street 1:3919 MAIN ST
Practice Address - Street 2:
Practice Address - City:FOLKSTON
Practice Address - State:GA
Practice Address - Zip Code:31537-7545
Practice Address - Country:US
Practice Address - Phone:912-496-3426
Practice Address - Fax:912-287-1568
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN177851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003111572CMedicaid