| Doctor Name: | MRS. KATHRYN RICKS TOBUREN |
| NPI Number: | 1033450820 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP-C |
| License Number: | RN113267 |
| Business Practice Address: | 465 N Belair Rd Suite 1-b Evans, GA - 308093188 |
| Business Phone Number: | 7068683100 |
| Business Fax Number: | 7062283160 |
| Mailing Address: | Po Box 1547, 465 North Belair Road Suite 1-b EVANS |
| State: | GA |
| Postal Code: | 308091547 |
| Phone Number: | 7068683100 |
| Fax Number: | 7062283160 |
| NPI Enumeration Date: | 03/05/2013 |
| NPI Last Update Date: | 03/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN113267 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |