Individual
JENNIFER SIMPSON ETHERIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1360 CADUCEUS WAY STE 105, WATKINSVILLE, GA 30677-7300
(706) 850-3795
(877) 580-1676
Mailing address
1360 CADUCEUS WAY STE 105, WATKINSVILLE, GA 30677-7300
(706) 850-3795
(877) 580-1676
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN222355
GA
363LA2200X
Adult Health Nurse Practitioner
Primary
RN222355
GA
Other
Enumeration date
01/22/2019
Last updated
03/11/2021
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