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General NPI Number Information
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NPI Number | 1356225544
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Entity Type | Organization
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Legal Business Name | BRIAR CREEK FAMILY CARE
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Dates
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Enumeration Date | 08/01/2025
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 639 VESTAL RD
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City | SARDIS
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State | GA
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Zip | 30456-2155
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Country | US
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Telephone | 706-834-3731
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHATHAM STREET EXT
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City | SARDIS
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State | GA
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Zip | 30456-2000
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Country | US
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Telephone | 706-834-3731
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STACIE D BUCKLEY
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Credential | FNP-C
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Telephone | 706-834-3731
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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 |
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License Number State |
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