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Pediatrics >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1831558451

Individual Registrant:
Gender: F
Not Sole Proprietor

Location and contact information for practice:
Tel: 706-788-2127  Fax: 706-788-2815

Contact information for business:
PO BOX 459  COLBERT, GA 30628-0459 US
Tel: 706-788-3234  Fax: 706-788-2936

Registration Information:
NPI: 1831558451
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LP0200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner

Legacy codes, insurance codes and state license numbers:



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