Individual
JETTIE ANNE CUMMINGS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
774 ATHENS RD, LEXINGTON, GA 30648-1908
(706) 743-8183
(706) 743-3233
Mailing address
PO BOX 69, LEXINGTON, GA 30648-0069
(706) 743-8183
(706) 743-3233
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R046865
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00510023A
—
GA
05
—
00665794A
—
GA
Enumeration date
07/13/2005
Last updated
07/09/2007
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