Suffearria Makia Daniels-Ellison, NURSE PRACTITIONER
Individual provider Active NPI Adult Health Nurse Practitioner · Swainsboro, GA
NPI 1497426845 · NPPES record last updated Sep 24, 2021
Key facts
- NPI
- 1497426845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 144562 (GA)
- Practice address
- 131A Victory Dr
Swainsboro, GA 30401-3234 - Phone
- (478) 237-8342
- Fax
- (478) 237-8281
- NPI assigned
- Sep 24, 2021
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 144562 | GA | MD | Adult Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 144562 | GA | Yes |
Addresses
Primary practice location
131A Victory Dr
Swainsboro, GA 30401-3234
Mailing address
85 N Lake Dr
Sandersville, GA 31082-7514
Phone (478) 290-2319
Other providers in Swainsboro, GA
- Janet Costley
- Debra L Crawley-Mataosky
- David W Crooke
- Crossroads Wellness PC
- Lydia Lee Daley
- Debbie Jean Davis
- Bobby Lee Derrick
- Vinh Dong
- Paul Andrew Dorsett
- Dr. WM. Allen Herren,LLC
All providers in Swainsboro, GA · Adult Health Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.