Provider Demographics
NPI:1396354619
Name:CUTTER, VONTEENA GIZELLE (NP)
Entity type:Individual
Prefix:MRS
First Name:VONTEENA
Middle Name:GIZELLE
Last Name:CUTTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:VONTEENA
Other - Middle Name:GIZELLE
Other - Last Name:KNOTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:237 SMITHVILLE CHURCH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7803
Mailing Address - Country:US
Mailing Address - Phone:478-238-5513
Mailing Address - Fax:478-254-3412
Practice Address - Street 1:237 SMITHVILLE CHURCH RD STE 100
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7803
Practice Address - Country:US
Practice Address - Phone:478-238-5513
Practice Address - Fax:478-254-3412
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN293740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily