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General NPI Number Information
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NPI Number | 1851651905
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Entity Type | Individual
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Provider Name | ALICIA PRESTON
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Gender | Female
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 417 W 3RD AVE
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City | ALBANY
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State | GA
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Zip | 31701-1943
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Country | US
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Telephone | 229-312-7900
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Fax | 229-312-7925
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Provider Business Mailing Address
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Address Line | 727 GILBERT LN
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City | ALBANY
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State | GA
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Zip | 31701-5415
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Country | US
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Telephone | 229-669-0039
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN178165
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License Number State | GA
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