Individual
JESSICA DENISE WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
109 E OGLETHORPE HWY, HINESVILLE, GA 31313-3657
(912) 368-2099
Mailing address
557 DRUM POINT WAY, MIDWAY, GA 31320-6747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008704
GA
363A00000X
Physician Assistant
PA2659
SC
Other
Enumeration date
11/22/2016
Last updated
11/30/2020
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