| Nedege Raybourne, | |
|
30 Cranbrook Way, Covington, GA 30016-9065 | |
| (470) 774-0789 | |
| Not Available |
| Full Name | Nedege Raybourne |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 30 Cranbrook Way, Covington, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386125516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN186313 (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | F04180532 (Georgia) | Primary |
| Entity Name | Medical Director Services PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1871955807 PECOS PAC ID: 0042501116 Enrollment ID: O20190301002321 |
| Entity Name | Hardy Renew Wellness,llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952914368 PECOS PAC ID: 2961812425 Enrollment ID: O20201112000534 |
| Entity Name | Georgia Mso LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952196164 PECOS PAC ID: 3173041639 Enrollment ID: O20250519001080 |
| Mailing Address | Practice Location Address |
|---|---|
| Nedege Raybourne, 30 Cranbrook Way, Covington, GA 30016-9065 Ph: Not Available | Nedege Raybourne, 30 Cranbrook Way, Covington, GA 30016-9065 Ph: (470) 774-0789 |
Ms. Tonecesa Burtton, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 85 Providence Pkwy, Covington, GA 30014 Phone: 770-462-9202 |
Mrs. Fredniki Ladoris Sanders, CRNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 4192 Salem Rd, Covington, GA 30016 Phone: 770-788-2026 |
Mrs. Melanie Marie Cox, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3792 Kraddle Creek Dr, Covington, GA 30014 Phone: 770-490-3350 |
Nicole Francis-freckleton, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13110 Greywolf Ln, Covington, GA 30014 Phone: 754-551-4480 |
Shelleyann Beaubrun, PMHNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 4136 Newton Dr Ne, Covington, GA 30014 Phone: 770-569-3205 |
Samantha Joi Tait, DNP, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4152 Baker St Ne, Covington, GA 30014 Phone: 770-788-1077 |
Mrs. Hannah Addis, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4181 Hospital Dr Ne, Suite 202, Covington, GA 30014 Phone: 770-728-1901 Fax: 770-728-1907 |