# JR HEALTH CONSULTANT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710635297
- **Authorized official:** NICK AMIN (CREDENTIALING)
- **Authorized official phone:** (717) 910-6512

## Contact information

- **Practice address:** 2548 WALNUT RIDGE WAY, STOCKBRIDGE, GA 30281-9214
- **Practice address phone:** (678) 876-7880
- **Mailing address:** 2548 WALNUT RIDGE WAY, STOCKBRIDGE, GA 30281-9214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 03/14/2022