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Contact Information

AMANDA LARISCEY, PA-C
122 ALICE COLEMAN DRIVE
VIDALIA, GA30474
 Phone: 912-805-2273
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for AMANDA LARISCEY · (Female)

NPI # 1780164590
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/21/2018
Last updated 01/07/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s)
  • MEADOWS REGIONAL MEDICAL CENTER - (Acute Care)
    ONE MEADOWS PARKWAY
    VIDALIA, GA 30474
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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