Baize, Theresa Elaine

Baize, Theresa Elaine is an individual health care provider with primary practice located at 3207 Country Club Dr , Valdosta GA 31605-1029. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Baize, Theresa Elaine can be contacted via phone (229) 242-8480.

Contact Information

Primary practice address
3207 Country Club Dr Valdosta GA 31605-1029
Phone: (229) 242-8480
Fax: (229) 241-0252
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 156046 Georgia

Profile Details

NPI number 1528106408
LBN Legal business name Baize, Theresa Elaine
Credentials FNP, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2007
Last updated Oct 21st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528106408 NPPES
Georgia Other 261356861 TRICARE

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