Healthcare Provider Details

I. General information

NPI: 1205671336
Provider Name (Legal Business Name): ABBY PATTERSON FELTS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2024
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 31ST AVE SE
MOULTRIE GA
31768-6703
US

IV. Provider business mailing address

PO BOX 2876
MOULTRIE GA
31776-2876
US

V. Phone/Fax

Practice location:
  • Phone: 229-798-9172
  • Fax: 229-891-9542
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN283602
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: