Healthcare Provider Details

I. General information

NPI: 1003744624
Provider Name (Legal Business Name): CAROL SHULER SEABOLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 ATHENS ST
GAINESVILLE GA
30507-7000
US

IV. Provider business mailing address

PO BOX 907649
GAINESVILLE GA
30501-0911
US

V. Phone/Fax

Practice location:
  • Phone: 770-531-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRNNP057845
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: