Individual
MS. JENNIFER H PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ARNP, CPNP
Contact information
Practice address
777 FRANKLIN RD SE, MARIETTA, GA 30067-7803
(770) 732-6007
(770) 732-8242
Mailing address
3355 GEORGE BUSBEE PKWY NW, APT. 1001, KENNESAW, GA 30144-6823
(214) 789-0423
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
628818
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152489401
—
TX
Enumeration date
05/19/2006
Last updated
02/04/2014
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