Individual
JENNIFER KRISTEN WAGNER-HITZEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
750 TOWNPARK LN NW, KENNESAW, GA 30144-5579
(404) 364-7285
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 504-5678
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
053370
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
864857914A
—
GA
Enumeration date
04/01/2006
Last updated
03/01/2022
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