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Individual

GERALD PIERRE JEAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NURSE PRACTITIONER

Contact information

Practice address
709 BREEDLOVE DR, MONROE, GA 30655-2055
(678) 635-5000
Mailing address
244 CHANDLER WALK, LOGANVILLE, GA 30052-3141
(781) 704-7576

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN255660
GA

Other

Enumeration date
03/08/2021
Last updated
03/08/2021
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