Individual
JENNIFER MICHELLE BASTECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
11459 JOHNS CREEK PKWY STE 250, DULUTH, GA 30097-3517
(770) 497-1555
Mailing address
350 LA PERLA DR, SUGAR HILL, GA 30518-6161
(770) 366-8853
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN223372
GA
Other
Enumeration date
12/13/2020
Last updated
12/13/2020
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