Individual
FAITH CAUSBEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
901 E 18TH ST, TIFTON, GA 31794
(229) 353-6208
(229) 353-7722
Mailing address
901 E 18TH ST, TIFTON, GA 31794
(229) 353-6208
(229) 353-7722
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
112129
GA
363L00000X
Nurse Practitioner
RN112129
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000936438B
—
GA
01
—
112129
LICENSE NUMBER
GA
Enumeration date
09/28/2006
Last updated
01/03/2014
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