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Individual
JONELL B. POE
Active
Individual
JONELL B. POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3209
GA
363AS0400X
Surgical Physician Assistant
003209
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112PA
—
SC
05
—
100001728A
—
GA
Enumeration date
09/25/2006
Last updated
11/15/2023
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