Individual
JAKE PAUL LUNDQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
63 PLEASANT HILL RD, BLAIRSVILLE, GA 30512-2291
(706) 745-2229
Mailing address
PO BOX 244, MC CAYSVILLE, GA 30555-0244
(716) 969-5687
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F09201627
GA
363LF0000X
Family Nurse Practitioner
RN244697
GA
Other
Enumeration date
11/21/2020
Last updated
09/20/2022
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