| Mrs Michelle Whitehead, RN | |
|
406 Central Dr, East Dublin, GA 31027-7412 | |
| (478) 488-3057 | |
| Not Available |
| Full Name | Mrs Michelle Whitehead |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 406 Central Dr, East Dublin, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336325679 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | RN184151 (Georgia) | Secondary |
| 363L00000X | Nurse Practitioner | RN184151 (Georgia) | Primary |
| Entity Name | Southeast Medical Group, P.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235296054 PECOS PAC ID: 3577559673 Enrollment ID: O20040423000347 |
| Entity Name | Infinite Medical Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407483175 PECOS PAC ID: 8325477656 Enrollment ID: O20201119003156 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Michelle Whitehead, RN 2121a Bellevue Rd, Dublin, GA 31021-2998 Ph: (478) 272-1190 | Mrs Michelle Whitehead, RN 406 Central Dr, East Dublin, GA 31027-7412 Ph: (478) 488-3057 |
Desha H Jones, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 406 Central Dr, East Dublin, GA 31027 Phone: 478-304-1412 | |
Ms. Amber Dashai King, MSN, APRN, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 406 Central Dr, East Dublin, GA 31027 Phone: 478-488-3057 |