Ethridge Speight, Katherine
Ethridge Speight, Katherine is an individual health care provider with primary practice located at 301 Margie Drive , Warner Robins GA 31088. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ethridge Speight, Katherine can be contacted via phone (478) 971-1153.Contact Information
Primary practice address
301 Margie Drive
Warner Robins GA 31088
Phone: (478) 971-1153
Fax: (178) 971-1173
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 006797 | Georgia |
Profile Details
| NPI number | 1497190979 |
|---|---|
| LBN Legal business name | Ethridge Speight, Katherine |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 9th, 2013 |
| Last updated | May 9th, 2013 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497190979 | NPPES |
| Georgia | Other | 006797 | STATE LICENSE |
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