Individual provider · Type 1 NPI
Michelle Jackson, APRN
Family Nurse Practitioner · Loganville, GA
NPI number
1649645730
Active
Practice location
4593 Lawrenceville Road
Loganville, GA 30052
Mailing address
PO Box 1908
Snellville, GA 30078-3326
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | ARNP 9171924 (FL) |
| Gerontology Nurse Practitioner | 363LG0600X | ARNP 9171924 (FL) |
| Family Nurse Practitioner Primary | 363LF0000X | 298929 (GA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1649645730
Michelle Jackson, APRN's National Provider Identifier is 1649645730, issued on Dec 1, 2015. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Loganville, GA. The record was last updated on Feb 25, 2021.