Etheridge, Tory Kirsten

Etheridge, Tory Kirsten is an individual health care provider with primary practice located at 688 Walnut St Ste 200 , Macon GA 31201-0333. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Etheridge, Tory Kirsten can be contacted via phone (478) 742-7566.

Contact Information

Primary practice address
688 Walnut St Ste 200 Macon GA 31201-0333
Phone: (478) 742-7566
Fax: (478) 743-2804
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 2017026648 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 2017026648 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 2017026648 Georgia

Profile Details

NPI number 1649771155
LBN Legal business name Etheridge, Tory Kirsten
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2018
Last updated Feb 21st, 2018 - about 7 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 1649771155 NPPES
Other RN223023 GA LICENSE

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