Provider Demographics
NPI:1063610905
Name:WAYBRIGHT, SUZANNE JEFFERS (RN)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:JEFFERS
Last Name:WAYBRIGHT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SUZANNE
Other - Middle Name:MICHELE
Other - Last Name:JEFFERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:4153 QUINN DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-4817
Mailing Address - Country:US
Mailing Address - Phone:706-854-0817
Mailing Address - Fax:
Practice Address - Street 1:2420 WINDSOR SPRING RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-4668
Practice Address - Country:US
Practice Address - Phone:706-790-2514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN166823163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health