Provider Demographics
NPI:1164075347
Name:GOLDEN ISLES HEALTHCARE,LLC
Entity Type:Organization
Organization Name:GOLDEN ISLES HEALTHCARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALARIE
Authorized Official - Middle Name:I
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:229-868-7342
Mailing Address - Street 1:144 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:MC RAE
Mailing Address - State:GA
Mailing Address - Zip Code:31055-4338
Mailing Address - Country:US
Mailing Address - Phone:229-868-7342
Mailing Address - Fax:229-868-4344
Practice Address - Street 1:144 E OAK ST
Practice Address - Street 2:
Practice Address - City:MC RAE
Practice Address - State:GA
Practice Address - Zip Code:31055-4338
Practice Address - Country:US
Practice Address - Phone:229-868-7342
Practice Address - Fax:229-868-4344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty