Individual
MRS. JESSICA LYNN STOCKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
101 DOCTORS DR, CARROLLTON, GA 30117-4486
(706) 766-1677
Mailing address
1001 BUCKEYE LN, VILLA RICA, GA 30180-5328
(706) 766-1677
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN236119
GA
363LF0000X
Family Nurse Practitioner
Primary
RN236119
GA
Other
Enumeration date
06/06/2018
Last updated
10/15/2019
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