| NPI | 1336692599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY BLANCHETT Practice Manager 229-391-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN089222) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2016-07-25 |