Individual
JACOB WILLIAM GOERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, ACNP-BC
Contact information
Practice address
550 PEACHTREE ST NE, OFFICE 3304 DAVIS-FISCHER BUILDING, ATLANTA, GA 30308-2208
(404) 686-7858
Mailing address
157 LAKE WELLINGTON DR, KINGSLAND, GA 31548-5733
(912) 227-1717
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN226582
GA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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