Healthcare Provider Details

I. General information

NPI: 1518722099
Provider Name (Legal Business Name): LINDA JOY SOSEBEE APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MARTIN LUTHER KING JR BLVD
MACON GA
31201-3490
US

IV. Provider business mailing address

99 COUNTRY CLUB DR
FORSYTH GA
31029-3102
US

V. Phone/Fax

Practice location:
  • Phone: 478-301-4111
  • Fax:
Mailing address:
  • Phone: 478-957-5764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN302431
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: