Individual
STACEY NEWSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(229) 333-1000
Mailing address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(850) 464-4021
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN184420
GA
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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