Individual
DOMONQUE LOUISE JAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4521 SADDLE BEND TRL, SNELLVILLE, GA 30039-5984
(323) 677-8457
Mailing address
4521 SADDLE BEND TRL, SNELLVILLE, GA 30039-5984
(323) 677-8457
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN282222
GA
Other
Enumeration date
03/27/2020
Last updated
03/27/2020
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