Healthcare Provider Details

I. General information

NPI: 1194339119
Provider Name (Legal Business Name): ELIZABETH SHERIDAN FLOYD MSN-RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 VETERANS BLVD
DUBLIN GA
31021-3620
US

IV. Provider business mailing address

2121A BELLEVUE RD BLDG 4
DUBLIN GA
31021-9073
US

V. Phone/Fax

Practice location:
  • Phone: 478-272-1210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN289282
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN289282
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: