Individual
PENNY L CHAMPION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
414 5TH AVE, ALBANY, GA 31701-1976
(229) 883-4555
(229) 888-0063
Mailing address
414 FIFTH AVENUE, ALBANY, GA 31701
(229) 883-4555
(229) 888-0063
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R079412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00787146A
—
GA
Enumeration date
08/30/2005
Last updated
12/09/2016
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