Individual
MRS. ANNIE DENISE STATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
100 MEDICAL PARK WAY, AMERICUS, GA 31709-3656
(229) 944-4031
Mailing address
100 MEDICAL PARK WAY, AMERICUS, GA 31709-3656
(229) 944-4031
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN111226
GA
Other
Enumeration date
07/10/2007
Last updated
06/23/2021
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