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General NPI Number Information
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NPI Number | 1164318408
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Entity Type | Individual
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Provider Name | VONEDTERA TOSHABA MACKLIN
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Gender | Female
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Dates
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Enumeration Date | 06/14/2025
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Last Update Date | 06/14/2025
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Provider Practice Location Address
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Address Line | 11935 ABERCORN STREET
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City | SAVANNAH
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State | GA
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Zip | 31419
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Country | US
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Telephone | 912-657-9732
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Fax |
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Provider Business Mailing Address
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Address Line | 11935 ABERCORN STREET
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City | SAVANNAH
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State | GA
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Zip | 31419-1918
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Country | US
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Telephone | 912-657-9732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN314573
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License Number State | GA
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