Individual
JASMINE DEIDRE HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3020 HOLCOMB BRIDGE RD, NORCROSS, GA 30071-1375
(404) 800-5181
(404) 800-5797
Mailing address
3020 HOLCOMB BRIDGE RD, NORCROSS, GA 30071-1375
(404) 800-5181
(404) 800-5797
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN191228
GA
363LF0000X
Family Nurse Practitioner
Primary
RN191228
GA
363LP2300X
Primary Care Nurse Practitioner
RN191228
GA
Other
Enumeration date
07/28/2023
Last updated
02/16/2026
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