Individual
JIANGNAN SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-1308
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN275221
GA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN275221
GA
363LF0000X
Family Nurse Practitioner
RN275221
GA
Other
Enumeration date
02/26/2018
Last updated
01/18/2024
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