Individual
JENNIFER WAITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 534-2020
(770) 534-8025
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN229350
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN229350
GEORGIA BOARD OF NURSING
GA
Enumeration date
10/09/2017
Last updated
12/07/2020
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