Individual provider · Type 1 NPI
Jacquiece Liddell, AGACNP
Acute Care Nurse Practitioner · Ellenwood, GA
NPI number
1467988543
Active
Practice location
4357 Boxwood Trl
Ellenwood, GA 30294-6518
Mailing address
4357 Boxwood Trail
Ellenwood, GA 30294
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | RN206975 (GA) |
Acute Care Nurse Practitioner: Definition to come...
Other acute care nurse practitioner providers in Ellenwood
About NPI 1467988543
Jacquiece Liddell, AGACNP's National Provider Identifier is 1467988543, issued on May 10, 2017. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Ellenwood, GA. The record was last updated on Nov 8, 2025.