Healthcare Provider Details

I. General information

NPI: 1467241216
Provider Name (Legal Business Name): MYRANDA LYNN HAND PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2025
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

485 CANAL RD
BRUNSWICK GA
31525-6721
US

IV. Provider business mailing address

415 WOODLAWN DR
JESUP GA
31545-7225
US

V. Phone/Fax

Practice location:
  • Phone: 912-264-9111
  • Fax:
Mailing address:
  • Phone: 912-547-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13143
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: