Provider Demographics
NPI:1992230221
Name:PIATT, LONNIE (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:LONNIE
Middle Name:
Last Name:PIATT
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6351 BLANCHARD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3675
Mailing Address - Country:US
Mailing Address - Phone:337-424-1947
Mailing Address - Fax:
Practice Address - Street 1:6351 BLANCHARD CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3675
Practice Address - Country:US
Practice Address - Phone:337-424-1947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN243145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily