Individual
HALI MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 382-7120
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN235410
GA
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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