Individual
MS. JACQUELINE DENISE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
108 N PARK DR, FAYETTEVILLE, GA 30214-1645
(770) 487-7807
Mailing address
PO BOX 11087, MONTGOMERY, AL 36111-0087
(334) 481-1599
(334) 356-1426
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
RN323435
GA
Other
Enumeration date
08/01/2019
Last updated
02/13/2025
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