Provider Demographics
NPI:1215519459
Name:DUNCAN, PATRICIA F (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:F
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 NAPIER AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-2753
Mailing Address - Country:US
Mailing Address - Phone:478-718-7331
Mailing Address - Fax:478-254-9736
Practice Address - Street 1:3780 NAPIER AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2753
Practice Address - Country:US
Practice Address - Phone:478-718-7331
Practice Address - Fax:478-254-9736
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAADC000177261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003211246Medicaid