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Individual

JACQUELINE CAROLYN EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
N.P., RN

Contact information

Practice address
8081 TARA BLVD, 265, JONESBORO, GA 30236
(678) 815-5446
(188) 829-1928
Mailing address
8081 TARA BLVD, 265, JONESBORO, GA 30236
(678) 815-5446
(188) 829-1928

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28131113A
IN
163W00000X
Registered Nurse
RN139678
GA
363LF0000X
Family Nurse Practitioner
71005657A
IN
363LF0000X
Family Nurse Practitioner
Primary
RN139678
GA

Other

Enumeration date
12/19/2014
Last updated
12/13/2016
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