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Contact Information

PHYLLIS R FOSSETT, CRNA
380 HOSPITAL DRIVE
SUITE 410
MACON, GA31217
 Phone: 478-746-5644
 Fax: 478-745-4849
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for PHYLLIS R FOSSETT · (Female)

NPI Number 1245207414
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 03/07/2006
Last updated 06/04/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • GA License # RN066808
  • GA Medicaid 000582788D
  • GA Medicaid 000582788E
  • GA Medicaid 000582788F
  • GA Other 430060612 PALMETTO GBA
  • GA Other 430032146 RAILROAD MEDICARE
  • GA Other 391026 WELLCARE
Hospital affiliation(s)
  • COLISEUM NORTHSIDE HOSPITAL - (Acute Care)
    400 CHARTER BOULEVARD
    MACON, GA 31210
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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