Individual
DR. JENNIFER BETH AQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
960 JOHNSON FERRY RD NE, STE 400, ATLANTA, GA 30342-4771
(404) 257-0170
(404) 851-9894
Mailing address
960 JOHNSON FERRY RD NE, STE 400, ATLANTA, GA 30342-4771
(404) 257-0170
(404) 851-9894
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
044882
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000804273V
—
GA
05
—
000804273W
—
GA
05
—
00804273R
—
GA
05
—
00804273U
—
GA
01
—
013526
BLUE CROSS BLUE SHIELD
GA
01
—
0701009
UNITED HEALTHCARE
GA
01
—
160052432
RAILROAD MEDICARE
GA
01
—
2624404
AETNA/USHC
GA
01
—
5857673
AETNA/USHC
GA
Enumeration date
07/02/2006
Last updated
11/29/2011
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