Individual
JARVIS REESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
775 POPLAR RD STE 130, NEWNAN, GA 30265-8307
(770) 683-6291
Mailing address
413 TUG CT, WARNER ROBINS, GA 31088-2134
(478) 718-3504
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN259527
GA
363LA2100X
Acute Care Nurse Practitioner
RN259527
GA
Other
Enumeration date
08/05/2020
Last updated
06/11/2021
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