Individual
MISS JACQUELENE LYNNETTE VARGAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
794 S PARK ST, CARROLLTON, GA 30117-3826
(404) 948-3019
Mailing address
641 NORTH AVE NE APT 3119, ATLANTA, GA 30308-3068
(708) 207-1531
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN276379
GA
363LF0000X
Family Nurse Practitioner
RN276379
GA
Other
Enumeration date
12/28/2022
Last updated
03/14/2023
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