Individual
DEBORAH CAROL STIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
228 MEMORIAL DR, JESUP, GA 31545-0102
(912) 530-6582
Mailing address
960 EDMONDSON RD, SCREVEN, GA 31560-7304
(912) 294-4846
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN119496
GA
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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