Individual
CENCEREITTE CANTY-JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
996 CHAPMAN DR, MACON, GA 31211-7214
(478) 232-4590
Mailing address
996 CHAPMAN DR, MACON, GA 31211-7214
(478) 232-4590
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN217763
GA
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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