Individual
JACEY LAINE DEVAUGHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1411 LANEY WALKER BLVD, AUGUSTA, GA 30912-4788
(706) 721-2505
(706) 721-5566
Mailing address
PO BOX 925, AUGUSTA, GA 30903-0925
(706) 854-6008
(706) 774-7230
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN258788
GA
Other
Enumeration date
08/16/2020
Last updated
04/25/2024
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