person
Jeanine M. Jackson, CNNP
Pediatric Nurse Practitioner in Gainesville, Georgia
NPI 1568434231

Jeanine M. Jackson is a Pediatric Nurse Practitioner based in Gainesville, GA and is specialized in Pediatrics. Jeanine M. Jackson practices in Gainesville, GA and has the professional credentials of CNNP. The NPI Number for Jeanine M. Jackson is 1568434231 and holds a License No. RN060702 (Georgia).

The current practice location address for Jeanine M. Jackson is 725 Jesse Jewell Pkwy Se, Gainesville, GA and can be reached out via phone at 770-535-3611 and via fax at 770-535-7092. You can also correspond with Jeanine M. Jackson through the mailing address at PO BOX 658, GAINESVILLE, GA - 30503-0658 (mailing address contact number: 770-718-1122).

Location: 725 Jesse Jewell Pkwy Se, Gainesville, GA, 30503-0658
person
Provider Profile Details
NPI Number
1568434231
Provider Name
Jeanine M. Jackson
Credential
CNNP
Provider Entity Type
Individual
Gender
Female
Address
725 Jesse Jewell Pkwy Se, Gainesville, GA, 30503-0658
Phone Number
770-535-3611
Fax Number
770-535-7092
Provider Enumeration Date
02/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000731497D 05 GA
302386 01 GA WELLCARE
000731497E 05 GA
000731497A 05 GA
302385 01 GA WELLCARE
000731497B 05 GA
000731497F 05 GA
302387 01 GA WELLCARE
10032991 01 GA AMERIGROUP
302375 01 GA WELLCARE
institution
Provider Business Practice Location Address Details
Address
725 Jesse Jewell Pkwy Se
City
State
Zip
30501-3834
Phone Number
770-535-3611
Fax Number
770-535-7092
person
Provider Business Mailing Address Details
Address
Po Box 658
City
State
Zip
30503-0658
Phone Number
770-718-1122
Fax Number
770-534-8998
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Neonatal
Taxonomy
License No.
RN060702 (Georgia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
RN060702 (Georgia)
Definition
Definition to come...
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