Individual
MRS. DEBRA J WEATHERALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
744 1ST ST, MACON, GA 31201-6840
(478) 633-7600
Mailing address
744 1ST ST, MACON, GA 31201-6840
(478) 633-7600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN116189
GA
Other
Enumeration date
07/22/2018
Last updated
09/30/2020
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