Healthcare Provider Details

I. General information

NPI: 1447644265
Provider Name (Legal Business Name): GRETA S SLAPPY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 W FRANKLIN ST
SYLVESTER GA
31791-1978
US

IV. Provider business mailing address

1013 W FRANKLIN ST
SYLVESTER GA
31791-7174
US

V. Phone/Fax

Practice location:
  • Phone: 229-776-2965
  • Fax: 229-776-4452
Mailing address:
  • Phone: 229-894-2913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN174272
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: