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Individual

MS. JAYNEE LEE FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
35 HOSPITAL RD, BLAIRSVILLE, GA 30512-3139
(706) 747-1036
(706) 747-1046
Mailing address
33920 US HIGHWAY 19 N, SUITE 214, PALM HARBOR, FL 34684-2654
(727) 779-9793
(727) 773-0674

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
9228873
FL
363L00000X
Nurse Practitioner
Primary
RN227177
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30010894
NH
Enumeration date
11/23/2005
Last updated
11/29/2016
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