Denise Michelle Averett, CEO

Individual provider Active NPI Contractor · Columbus, GA

NPI 1366089773 · NPPES record last updated Dec 4, 2019

Key facts

NPI
1366089773
Entity type
Individual (NPI type 1)
Primary specialty
Contractor 171W00000X
Practice address
5401 Gunboat Dr Ste 33
Columbus, GA 31907-1498
Phone
(706) 888-0155
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X Yes

Addresses

Primary practice location

5401 Gunboat Dr Ste 33
Columbus, GA 31907-1498

Mailing address

5401 Gunboat Dr Ste 33
Columbus, GA 31907-1498
Phone (706) 888-0155

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL services.of.columbusga@gmail.com Direct

Other providers in Columbus, GA

All providers in Columbus, GA · Contractor in Georgia

Sources for this page

Verify at the official NPI Registry.