Ebony D Stubbins, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN225774 Issued in GA

Practice address

3000 Veterans Pkwy S
Moultrie, GA 31788-7762

Phone

(229) 985-3422

NPI assigned

Jun 12, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1508540402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 42ND ST E",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941550",
            "telephone_number": "229-326-2164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 VETERANS PKWY S",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317887762",
            "telephone_number": "229-985-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBBINS",
        "first_name": "EBONY",
        "middle_name": "D",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN225774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.