Individual
LIZ HUTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 DONEHOO ST, STATESBORO, GA 30458-5169
(912) 764-8441
Mailing address
200 DONEHOO ST, STATESBORO, GA 30458-5169
(912) 764-8441
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN149443
GA
Other
Enumeration date
03/06/2021
Last updated
03/06/2021
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