Individual
ALISSA GAIL BABCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
254 FURYS FERRY RD, AUGUSTA, GA 30907-3118
(706) 986-0999
Mailing address
6054 VERMILION LOOP, GRANITEVILLE, SC 29829-3258
(910) 964-3669
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
265501
SC
363L00000X
Nurse Practitioner
28302
SC
363L00000X
Nurse Practitioner
5023561
NC
363L00000X
Nurse Practitioner
Primary
GAA-NP002092
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GAA-NP002092
LICENSE
GA
Enumeration date
11/15/2023
Last updated
04/13/2026
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