Individual
JESSICA SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
107 B FAHM ST, SAVANNAH, GA 31401
(912) 651-2253
(912) 651-2366
Mailing address
107 B FAHM ST, SAVANNAH, GA 31401
(912) 651-2253
(912) 651-2366
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN087366
GA
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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