Individual
JUDY LYNN HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6381 ZEBULON RD, MACON, GA 31220-2601
(478) 476-1911
Mailing address
548 COMMANCHE DR, MACON, GA 31210-4205
(478) 719-5544
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN125871
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286678650A
—
GA
01
—
GRP6042
MEDICARE
GA
01
—
P00779970
RR MEDICARE
GA
01
—
RN125871
LICENSE
GA
Enumeration date
07/09/2008
Last updated
03/07/2023
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