Individual
TINA MARIE ELSENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 463-5194
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
275885
GA
163WP2201X
Ambulatory Care Registered Nurse
Primary
275885
GA
Other
Enumeration date
08/21/2013
Last updated
01/23/2024
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