Healthcare Provider Details

I. General information

NPI: 1235307851
Provider Name (Legal Business Name): ETHELIND WAITHE MCGEE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2008
Last Update Date: 01/10/2022
Certification Date: 01/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 MOUNTAIN VIEW DR YES
COVINGTON GA
30016-3001
US

IV. Provider business mailing address

475 MOUNTAIN VIEW DR YES
COVINGTON GA
30016-7104
US

V. Phone/Fax

Practice location:
  • Phone: 678-923-0468
  • Fax:
Mailing address:
  • Phone: 678-923-0468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN078939
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163WC1600X
TaxonomyContinuing Education/Staff Development Registered Nurse
License NumberRN078939
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License NumberRN078939
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN078939
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN078939
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN078939
License Number StateGA
# 7
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN078939
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: