Individual
CHARLES JORDY REWIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
228 MEMORIAL DR, JESUP, GA 31545-0102
(912) 352-1700
Mailing address
1921 ALICE ST STE 4B, WAYCROSS, GA 31501-6257
(912) 385-5690
(912) 285-1753
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN248151
GA
363LA2200X
Adult Health Nurse Practitioner
RN248151
GA
Other
Enumeration date
02/18/2019
Last updated
08/26/2021
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