Individual
JENNIFER S STOVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2650 FARLEY ST, ATLANTA, GA 30344-2327
(678) 235-1982
Mailing address
2650 FARLEY ST, ATLANTA, GA 30344-2327
(678) 235-1982
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CN0019441060
GA
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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