Most Relevant Information
Provider Data
| NPI Number: | 1003589631 |
| Provider Name: | KATIE ANN GRESHAM APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | RN235791 |
Most Important Dates
| Enumeration Date: | 07/29/2021 |
| Last Updated: | 09/30/2021 |
Provider Practice Location
4720 WASHINGTON RD
EVANS
GA
308095875
Practice Location Phone/Fax
| Phone: | 7067747760 |
| Fax: |
Provider Mailing Location
PO BOX 1705
AUGUSTA
GA
309031705
Provider Mailing Phone/Fax
| Phone: | 7068546008 |
| Fax: | 7067747230 |