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Individual

JENNIFER FAILLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2415 PARKWOOD DR, BRUNSWICK, GA 31520-4722
(912) 466-7000
Mailing address
200 DRIFTWOOD DR APT 1, SAINT SIMONS ISLAND, GA 31522-3805
(678) 591-9474

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN264688
GA
367500000X
Certified Registered Nurse Anesthetist
APRN11025891
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN264688
GA

Other

Enumeration date
05/16/2022
Last updated
03/04/2026
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