Individual
JESSICA R. TALLES-ERIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4750 WATERS AVE STE 202, SAVANNAH, GA 31404
(912) 350-7412
(912) 350-7297
Mailing address
4750 WATERS AVE STE 202, SAVANNAH, GA 31404-6278
(912) 350-7412
(912) 350-7297
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007940
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
GA
Enumeration date
03/01/2016
Last updated
08/09/2018
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