Individual
JENNIE MATHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
4120 FIVE FORKS TRICKUM RD SW STE 105, LILBURN, GA 30047-8975
(404) 778-0421
Mailing address
1897 INNSFAIL DR, SNELLVILLE, GA 30078-2525
(678) 458-3820
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
RN224236
GA
363LF0000X
Family Nurse Practitioner
Primary
RN224236
GA
Other
Enumeration date
01/21/2016
Last updated
12/12/2025
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