Individual
HOLLI BAILEY EASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
213 N MCDONALD ST STE A&B, LUDOWICI, GA 31316
(912) 545-9398
(912) 545-2747
Mailing address
1524 AD EASON RD, CLAXTON, GA 30417-3738
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN116108
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003207281A
—
GA
01
—
RN116108
PROVIDER LICENSE
GA
Enumeration date
05/30/2018
Last updated
08/17/2018
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