Organization
ATLANTA VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELODYE MARGUERITE JACOBS RN (CHARGE NURSE)
(404) 321-6111
Entity
Organization
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
(404) 329-4632
Mailing address
630 CREEKVIEW BLVD, COVINGTON, GA 30016-3085
(770) 385-7377
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
R109830
GA
Other
Enumeration date
06/29/2006
Last updated
08/22/2020
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