Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Penny D Booth, CFNP

Individual provider Family Nurse Practitioner · NPI 1710078423

Penny D Booth, CFNP is a Nurse Practitioner in Tifton, Georgia. Qualified in 2004, 22 years ago. Practices with Tift Regional Health System Inc, a 292-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
22
Licensed in
GA
In the registry since
2006
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Practice location Address checks out

901 18th St E
Tifton, GA 31794-3648
Phone: (229) 382-7120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN202921 (GA)

Record details

NPI number1710078423
Entity typeIndividual (Type 1)
GenderFemale
Credentials CFNP
Sole proprietorNo
NPI enumeratedSeptember 27, 2006
Last updated in NPPESMarch 30, 2021
Certification dateMarch 6, 2021
Mailing address907 18th St E Ste 400, Tifton, GA 31794-3684

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Tift Regional Health System Inc — 292 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Tifton