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General NPI Number Information
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NPI Number | 1215189865
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Entity Type | Individual
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Provider Name | CINDIA POOLE DUBRAVCIC NP
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Gender | Female
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Dates
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Enumeration Date | 10/15/2008
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Last Update Date | 06/01/2015
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Provider Practice Location Address
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Address Line | 2802 MOORE HWY ABAC
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City | TIFTON
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State | GA
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Zip | 31793-5679
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Country | US
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Telephone | 229-391-5030
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 MOORE HWY ABAC 52
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City | TIFTON
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State | GA
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Zip | 31793-5679
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Country | US
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Telephone | 229-391-5030
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9330736
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN069794
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License Number State | GA
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