Individual
MRS. JENNIFER ANN GEORGIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2300 HAGGERTY RD, STE 1110, WEST BLOOMFIELD, MI 48323
(248) 669-2000
(248) 669-2110
Mailing address
2300 HAGGERTY RD, STE 1110, WEST BLOOMFIELD, MI 48323
(248) 669-2000
(248) 669-2110
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601007054
MI
363AS0400X
Surgical Physician Assistant
5601007054
MI
Other
Enumeration date
04/07/2011
Last updated
04/21/2026
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