Individual
NIKKI CREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPH
Contact information
Practice address
200 SUDDETH ST, WINTERVILLE, GA 30683-1901
(706) 338-5544
Mailing address
200 SUDDETH ST, WINTERVILLE, GA 30683-1901
(706) 338-5544
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
003228695A
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003228695A
—
GA
Enumeration date
08/25/2020
Last updated
08/25/2020
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