Provider Demographics
NPI:1710497060
Name:LAYSON, RACHEL ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:LAYSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 ASBELL WAY
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31028-1395
Mailing Address - Country:US
Mailing Address - Phone:478-335-8547
Mailing Address - Fax:
Practice Address - Street 1:6005 WATSON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BYRON
Practice Address - State:GA
Practice Address - Zip Code:31008-6542
Practice Address - Country:US
Practice Address - Phone:478-956-5002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-01
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN203400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily