Individual
DR. JENNIFER ROBERTS EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2416 CAPSTONE CT, COLUMBUS, GA 31909-2795
(706) 327-1281
(706) 576-9714
Mailing address
2416 CAPSTONE CT, COLUMBUS, GA 31909-2795
(706) 327-1281
(706) 576-9714
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
043037
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043037
MEDICAL LICENSE
GA
Enumeration date
08/24/2006
Last updated
03/07/2023
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