Individual
JENNIFER ANN HALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C #F05200177
Contact information
Practice address
11909 MCAULEY DR STE 1002A, SAVANNAH, GA 31419-1793
(912) 354-8331
Mailing address
836 E 65TH ST STE 22, SAVANNAH, GA 31405-4493
(912) 414-6034
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
RN196020
GA
363L00000X
Nurse Practitioner
Primary
RN196020
GA
Other
Enumeration date
09/24/2020
Last updated
11/10/2020
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