Individual
JACOB ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
275 COLLIER RD NW, SUITE 500, ATLANTA, GA 30309-1709
(404) 605-2800
(404) 351-5983
Mailing address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 605-2800
(404) 351-5983
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN195213
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003164255A
—
GA
Enumeration date
06/19/2015
Last updated
09/22/2015
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