Individual
JESSICA B WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
153 INDEPENDENCE DR, CARROLLTON, GA 30116-9000
(770) 836-6678
(770) 830-2266
Mailing address
153 INDEPENDENCE DR, CARROLLTON, GA 30116-9000
(770) 836-6678
(770) 830-2266
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN090183
GA
Other
Enumeration date
03/27/2018
Last updated
03/27/2018
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