Individual
JENNIFER M VAN VLERAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1120 15TH ST BA BA 1411, AUGUSTA, GA 30912-5110
(706) 721-8220
(706) 721-6360
Mailing address
1120 15TH ST # BA1411, AUGUSTA, GA 30912-0004
(706) 721-4188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
195498
GA
Other
Enumeration date
05/06/2019
Last updated
02/21/2024
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