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1205229531
SHANITA SOUTHERLAND AUSBORN
MACON, GA
NPI
1205229531
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN203226)
Enumeration Date
2015-03-11
Last Update Date
2022-02-15
Business Address
SHANITA SOUTHERLAND AUSBORN APRN
770 WALNUT ST
MACON, GA 31201-7307
Phone number: 478-787-4266
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Mailing Address
SHANITA SOUTHERLAND AUSBORN APRN
770 WALNUT ST
MACON, GA 31201-7307
Phone number: 478-787-4266
Copy
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