Healthcare Provider Details
I. General information
NPI: 1740244235
Provider Name (Legal Business Name): SHELIA CLYDE RAMER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7950 MARTIN LOOP
FORT BENNING GA
31905-5647
US
IV. Provider business mailing address
4136 FACEVILLE HWY
BAINBRIDGE GA
39819-6205
US
V. Phone/Fax
- Phone: 706-544-1442
- Fax: 706-544-1493
- Phone: 229-243-0907
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | RN085730 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: