Individual
EDWARD WITHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6761
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6761
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
225479
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
225479
BOARD OF NURSING
NC
Enumeration date
09/03/2014
Last updated
09/03/2014
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