Individual
MARY B. JAHR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC, PMHS-BC
Contact information
Practice address
3911 MARY ELIZA TRCE NW, SUITE 200, MARIETTA, GA 30064-1086
(678) 384-3480
(678) 384-3481
Mailing address
3911 MARY ELIZA TRCE NW STE 500, MARIETTA, GA 30064-1089
(678) 384-3480
(678) 384-3481
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
138345
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00978436D
—
GA
Enumeration date
01/08/2007
Last updated
02/01/2023
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