TORY KIRSTEN ETHERIDGE

MACON, GA
NPI1649771155
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: GA  2017026648)
Additional Taxonomies363LA2100X Nurse Practitioner, Acute Care
(Licence: GA  2017026648)
363LG0600X Nurse Practitioner, Gerontology
(Licence: GA  2017026648)
Enumeration Date2018-02-21
Last Update Date2018-02-21
Business Address
TORY KIRSTEN ETHERIDGE NP
688 WALNUT ST STE 200
MACON, GA 31201-0333
Phone number: 478-742-7566
Mailing Address
TORY KIRSTEN ETHERIDGE NP
688 WALNUT ST STE 200
MACON, GA 31201-0333
Phone number: 478-742-7566