Individual
JULIE LABISTE EJANDRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
304 N WESTBERRY ST, SYLVESTER, GA 31791-2125
(229) 463-7071
(229) 463-7081
Mailing address
4196 HIGHWAY 62 412 STE A, HARDY, AR 72542-8002
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN305884
GA
Other
Enumeration date
02/13/2025
Last updated
05/22/2025
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