Individual
BRIAN BATES SHIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-4400
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 734-6100
(706) 724-1600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
137551
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137551
APRN LICENSE
GA
Enumeration date
09/03/2008
Last updated
02/03/2015
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