Individual
LAUREN A JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10 MARKET SQUARE WAY, SUITE 100, NEWNAN, GA 30265
(678) 423-5560
(678) 423-5563
Mailing address
10 MARKET SQUARE WAY, SUITE 100, NEWNAN, GA 30265-6078
(678) 423-5560
(678) 423-5563
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006233
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003119030
—
GA
05
—
003119030B
—
GA
Enumeration date
10/31/2011
Last updated
07/28/2015
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