Individual
PAIGE N HERRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1014 MOORE AVENUE, AUGUSTA, GA 30904-3741
(706) 721-8623
Mailing address
1120 15TH ST STE BI1056, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN244568
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/06/2020
Last updated
04/02/2021
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