Healthcare Provider Details

I. General information

NPI: 1720995723
Provider Name (Legal Business Name): NURTURING FAMILY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2607 VINEVILLE AVE STE 107
MACON GA
31204-0900
US

IV. Provider business mailing address

2607 VINEVILLE AVE STE 107
MACON GA
31204-0900
US

V. Phone/Fax

Practice location:
  • Phone: 478-288-8784
  • Fax: 478-254-9157
Mailing address:
  • Phone: 478-288-8784
  • Fax: 478-254-9157

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LEIA GIDDENS
Title or Position: OWNER
Credential: BS
Phone: 478-288-8784