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Penny D Booth, CFNP
Family Nurse Practitioner in Tifton, Georgia
NPI 1710078423

Penny D Booth is a Family Nurse Practitioner based in Tifton, GA and is specialized in Family. Penny D Booth practices in Tifton, GA and has the professional credentials of CFNP. The NPI Number for Penny D Booth is 1710078423 and holds a License No. RN202921 (Georgia).

The current practice location address for Penny D Booth is 901 18Th St E, Tifton, GA and can be reached out via phone at 229-382-7120.

Location: 901 18Th St E, Tifton, GA, 31794-3684
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710078423
Provider Name
Penny D Booth
Credential
CFNP
Provider Entity Type
Individual
Gender
Female
Address
901 18Th St E, Tifton, GA, 31794-3684
Phone Number
229-382-7120
Fax Number
Provider Enumeration Date
09/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000270634 05 OH
3810004243 05 WV
2933277 05 OH
institution
Provider Business Practice Location Address Details
Address
901 18Th St E
City
Tifton
State
Georgia
Zip
31794-3648
Phone Number
229-382-7120
Fax Number
person
Provider Business Mailing Address Details
Address
901 18Th St E
City
Tifton
State
Georgia
Zip
31794-3648
Phone Number
229-382-7120
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
RN202921 (Georgia)
Definition
Definition to come...
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