Individual provider · Type 1 NPI

Jack Anthony Miceli, NP-C

Nurse Practitioner · Rome, GA

NPI number 1821623232 Active

Practice location

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Fax (706) 238-8081

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000XRN242971 (GA)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1821623232

Jack Anthony Miceli, NP-C's National Provider Identifier is 1821623232, issued on Mar 5, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Rome, GA. The record was last updated on Oct 24, 2023.