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Individual

MRS. ELENA VICTORIA FERCILIEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1361 JENNINGS MILL RD STE 201, WATKINSVILLE, GA 30677-7292
(706) 316-1908
(706) 316-2062
Mailing address
1361 JENNINGS MILL RD STE 201, WATKINSVILLE, GA 30677-7292
(706) 316-1908
(706) 316-2062

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9277
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00958625A
GA
Enumeration date
10/29/2018
Last updated
10/10/2022
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