Individual
DEIDRA MIESHA PRINTUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1267 HIGHWAY 54 W STE 3200, FAYETTEVILLE, GA 30214-2111
(770) 632-9900
Mailing address
1948 OLD OCILLA RD, TIFTON, GA 31794-1644
(229) 391-3500
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN223974
GA
Other
Enumeration date
11/21/2023
Last updated
10/10/2025
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