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ASHLEY SUZAM NORDSTROM PA-C
>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1568636306
Individual Registrant: ASHLEY SUZAM NORDSTROM PA-C
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
898 COLLEGE ST SUITE A MONTICELLO, GA 31064-1258 US
Tel: 706-468-0988 Fax: 706-468-6631
Tel: 706-468-0988 Fax: 706-468-6631
Contact information for business:
898 COLLEGE ST SUITE A MONTICELLO, GA 31064-1258 US
Tel: 706-468-0988 Fax: 706-468-6631
Tel: 706-468-0988 Fax: 706-468-6631
Registration Information:
NPI: 1568636306
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers Physician Assistant | GA | 005296 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 003141276A | GA | 05 |
