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Individual

KATHERINE ETHRIDGE SPEIGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
301 MARGIE DRIVE, WARNER ROBINS, GA 31088
(478) 971-1153
(178) 971-1173
Mailing address
301 MARGIE DRIVE, WARNER ROBINS, GA 31088
(478) 971-1153
(178) 971-1173

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006797
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006797
STATE LICENSE
GA
Enumeration date
05/09/2013
Last updated
12/17/2024
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