Individual
SIDNEY DONETTE MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5500
Mailing address
1150 NW 72ND AVE STE 455, MIAMI, FL 33126-1947
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
GAA-NP001222
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
GAA-NP003512
GA
Other
Enumeration date
12/13/2022
Last updated
09/15/2025
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