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Individual

ELIZABETH RUTH MCKNIGHT MATHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
710 CENTER ST, COLUMBUS, GA 31901-1527
(706) 571-1220
(706) 571-1070
Mailing address
PO BOX 1038, COLUMBUS, GA 31902-1038
(706) 660-6410

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN160912
GA
363LP0200X
Pediatric Nurse Practitioner
RN160912
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202735123D
GA
Enumeration date
09/29/2008
Last updated
10/31/2024
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