Individual provider · NPI-1

Eliza Johnson Bacot, NP

Nurse Practitioner, Critical Care Medicine · Newnan, GA

NPI number1891973483
StatusActive
Last updated in NPPESNov 17, 2014

Details

NPI
1891973483
Entity type
Individual (NPI-1)
Name
Eliza Johnson Bacot
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Feb 5, 2008
Last updated
Nov 17, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LC0200X Nurse Practitioner, Critical Care MedicineRN168366GAYes

Practice location

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Phone 678-907-2999

Mailing address

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Phone 678-907-2999

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