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Sidney Donette Medina
Gerontology Nurse Practitioner in Lagrange, Georgia
NPI 1437861168

Sidney Donette Medina is a Gerontology Nurse Practitioner based in Fort Benning, GA and is specialized in Gerontology. Sidney Donette Medina practices in Lagrange, GA. The NPI Number for Sidney Donette Medina is 1437861168 and holds a License No. GAA-NP001222 (Georgia).

The current practice location address for Sidney Donette Medina is 1075 Lafayette Pkwy, Lagrange, GA and can be reached out via phone at 706-443-5273.

Location: 1075 Lafayette Pkwy, Lagrange, GA, 31905-2303
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1437861168
Provider Name
Sidney Donette Medina
Credential
Provider Entity Type
Individual
Gender
Female
Address
1075 Lafayette Pkwy, Lagrange, GA, 31905-2303
Phone Number
706-443-5273
Fax Number
Provider Enumeration Date
12/13/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1075 Lafayette Pkwy
City
Lagrange
State
Georgia
Zip
30241-3504
Phone Number
706-443-5273
Fax Number
person
Provider Business Mailing Address Details
Address
1075 Lafayette Pkwy
City
Lagrange
State
Georgia
Zip
30241-3504
Phone Number
706-443-5273
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
GAA-NP001222 (Georgia)
Definition
Definition to come...
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