Individual
JENNIFER MICHELE STANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
(478) 301-4111
(478) 301-5812
Mailing address
250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
(478) 301-2362
(478) 301-2272
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN135249
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/29/2014
Last updated
11/23/2020
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