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Organization

NORTHEAST GEORGIA MEDICAL CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARY ELIZABETH FAIRCHILDS ACNP-BC (MID LEVEL PROVIDER)
(864) 314-9526
Entity
Organization

Contact information

Practice address
115 MELIA LN, ANDERSON, SC 29625-6361
(864) 314-9526
Mailing address
115 MELIA LN, ANDERSON, SC 29625-6361
(864) 314-9526

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN205146
GA

Other

Enumeration date
11/07/2012
Last updated
03/14/2013
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