Individual
JENNIFER MARIE PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
775 POPLAR RD, SUITE 260, NEWNAN, GA 30265
(770) 502-2150
(770) 502-2103
Mailing address
775 POPLAR ROAD, STE 260, NEWNAN, GA 30265
(770) 502-2150
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA001059
GA
363L00000X
Nurse Practitioner
Primary
RN270176
GA
363LF0000X
Family Nurse Practitioner
RN270176
GA
Other
Enumeration date
12/29/2006
Last updated
12/20/2022
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