Individual
JENNIFER ROSE LIECHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 MARBLE MILL RD NW, MARIETTA, GA 30060-1047
(770) 425-7575
(770) 425-7568
Mailing address
111 MARBLE MILL RD NW STE 300, MARIETTA, GA 30060-1047
(707) 425-7575
(770) 425-7568
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN186511
GA
Other
Enumeration date
06/29/2012
Last updated
01/08/2020
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