Individual
KALIE DEANN MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
505 CITY BLVD, WAYCROSS, GA 31501-8003
(912) 490-2229
Mailing address
360 E WASHINGTON DR, WAYCROSS, GA 31503-0680
(912) 548-4230
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN279071
GA
363LP0200X
Pediatric Nurse Practitioner
RN279071
GA
Other
Enumeration date
08/16/2021
Last updated
09/12/2023
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