Individual
REBECCA BRYANT JOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4545 E SHEA BLVD, STE. 175, PHOENIX, AZ 85028-3074
(602) 464-5200
Mailing address
155 GROGANS LNDG, SANDY SPRINGS, GA 30350-3131
(770) 393-8366
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
147381
GA
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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