CMS NPPES uses NUCC taxonomy code 363LA2100X for provider records classified as Acute Care within Nurse Practitioner. The taxonomy identifies the category reported on the NPI record; it does not by itself verify services offered,...
GA license #APRN-NP170526taxonomy 363LA2100X
Nurse Practitioner
CMS NPPES uses NUCC taxonomy code 363LF0000X for provider records classified as Family within Nurse Practitioner. The taxonomy identifies the category reported on the NPI record; it does not by itself verify services offered, current...
GA license #APRN-NP170526taxonomy 363LF0000X
Medicare directory context
Attributes below come from the CMS Doctors & Clinicians dataset used by Medicare Care Compare,
retrieved 2026-10-12. They apply only to this clinician's public Medicare listing.
Medicare specialties
Nurse Practitioner
Medical school
University Of South Alabama College Of Medicine
Graduation year 2014
Largest Medicare group
294 members
Largest listed enrollment group
Facility affiliations reported by CMS
Crisp Regional Hospital Inc
Tift Regional Health System Inc
Medicare listing data does not guarantee that a clinician is accepting new patients or that a service is covered.
View the CMS dataset →
Practice context
Part of a multi-provider practice. 180 other active providers share this practice address in NPPES.
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