Healthcare Provider Details

I. General information

NPI: 1902720659
Provider Name (Legal Business Name): MARY GAHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N SLAPPEY BLVD
ALBANY GA
31701-1413
US

IV. Provider business mailing address

701 N SLAPPEY BLVD
ALBANY GA
31701-1413
US

V. Phone/Fax

Practice location:
  • Phone: 229-439-1950
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP258578
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: