Provider Demographics
NPI:1083339220
Name:SCHALES, MISTY MICHELLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:MICHELLE
Last Name:SCHALES
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 HALEYS PLACE DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-4074
Mailing Address - Country:US
Mailing Address - Phone:912-506-5633
Mailing Address - Fax:
Practice Address - Street 1:650 SCRANTON RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-1927
Practice Address - Country:US
Practice Address - Phone:912-289-9273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN209030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily