Individual
JODI MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 LATHEMS MILL LN, BALL GROUND, GA 30107-7906
(678) 595-7227
Mailing address
115 LATHEMS MILL LN, BALL GROUND, GA 30107-7906
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN122137
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN122137
ADVANCED PRACTICE-NP
GA
Enumeration date
01/24/2018
Last updated
01/24/2018
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