Individual
JENNA CORINNE COON FUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1700 TREE LN STE 320, SNELLVILLE, GA 30078-6747
(770) 972-7999
Mailing address
221 MICHIGN ST NE STE 402, GRAND RAPIDS, MI 49503-2538
(616) 391-1405
(616) 391-8611
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301115839
MI
208600000X
Surgery Physician
4351035412
MI
208600000X
Surgery Physician
Primary
96435
GA
Other
Enumeration date
07/17/2018
Last updated
10/11/2023
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