NPI 1093816662

Shonta K Winbush, PA

Practitioner Physician Assistant Valdosta, GA

Practice location

Address: 704 Gil Harbin Ind Blvd, Valdosta, GA 31602
Phone: (229) 242-9003
Fax: (229) 242-0490
Mailing address: PO Box 148, Quitman, GA 31643

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 3776 (GA)

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Registry record

NPI: 1093816662
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Sep 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.