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NPI Code Detail

MEDICARE: MRS. SUZANNE JEFFERS WAYBRIGHT RN

MEDICARE:  MRS. SUZANNE JEFFERS WAYBRIGHT  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC1500XCommunity Health Registered NurseRN166823GA

General Provider Information

NPI Number : 1063610905
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUZANNE JEFFERS WAYBRIGHT RN
Provider Business Mailing Address
First Line : 4153 QUINN DR
Second Line :
City : EVANS
State : GA
Zip : 30809-4817
Country : US
Telephone Number : 706-854-0817
Fax Number :
Provider Business Practice Location Address
First Line : 2420 WINDSOR SPRING RD
Second Line :
City : AUGUSTA
State : GA
Zip : 30906-4668
Country : US
Telephone Number : 706-790-2514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. SUZANNE JEFFERS WAYBRIGHT RN” Practice Location

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