Individual
JAINE SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
865 N HIGHLAND AVE NE, ATLANTA, GA 30306
(404) 733-6089
Mailing address
865 N HIGHLAND AVE NE, ATLANTA, GA 30306-4565
(404) 733-6089
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN275872
GA
Other
Enumeration date
03/29/2013
Last updated
07/15/2018
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