Individual
MARY CATHERINE WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
745 POPLAR RD, NEWNAN, GA 30265-1618
(770) 400-1000
Mailing address
546 POPLAR ST APT 2, MACON, GA 31201-2788
(478) 960-4330
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN207217
GA
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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