Provider profile · NPI 1124062112
84pediatrix Medical Group University Hospital Augusta Ga.
Nurse Practitioner, Neonatal · Augusta, GA · NPI 1124062112 · No federal exclusion match
✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.
Registry details
Type
Organization
Primary specialty
Nurse Practitioner, Neonatal
Enumerated
Jun 16, 2006
License(s)
RN042192 (GA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 4227 QUAIL SPRINGS CIR | Martinez, GA 30907-4610 | 706-863-4975 |
| LOCATION | 1350 WALTON WAY | Augusta, GA 30901-2629 | 706-774-8948 |
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