Individual
TINA L. HATHAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 HILL POND LN, STATESBORO, GA 30458-0872
(912) 681-6944
(912) 681-8744
Mailing address
114 HILL POND LN, STATESBORO, GA 30458-0872
(912) 681-6944
(912) 681-8744
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN165131
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN165131
NURSING LICENSE
GA
Enumeration date
10/18/2017
Last updated
02/03/2026
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