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Individual

MRS. JENNY LEE CHARLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
711 4TH ST, AUGUSTA, GA 30901-2403
(706) 723-6015
Mailing address
711 4TH ST, AUGUSTA, GA 30901-2403
(706) 723-6015

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
APRN4139
SC
363LA2200X
Adult Health Nurse Practitioner
Primary
RN241333
GA

Other

Enumeration date
05/03/2008
Last updated
11/17/2014
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