Benaissa Kaddour Djebbar
Nurse Practitioner, Family in Augusta, GA. Individual provider (NPI-1).
NPI number1114200029
StatusActive
Last updated in NPPESSep 27, 2011
Details
- NPI
- 1114200029
- Entity type
- Individual (NPI-1)
- Name
- Benaissa Kaddour Djebbar
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 27, 2011
- Last updated
- Sep 27, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | APRN 204732 | GA | Yes |
Practice location
3405 Mike Padgett HwyEast Central Regional Hospital -Forensic Unit
Augusta, GA 30906-3815
Phone 706-792-7073
Mailing address
2060 Dundee WayGrovetown, GA 30813-8124
Phone 706-627-3762
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All 263 Family Nurse Practitioner providers in Augusta · All 8,576 providers in Augusta
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