Individual
JENNIFER L DENSMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
820 MAPLE ST, CARROLLTON, GA 30117-3626
(678) 390-7900
(678) 390-7901
Mailing address
3941 BROKEN HORN CT, DOUGLASVILLE, GA 30135-4295
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
169400
GA
363LP2300X
Primary Care Nurse Practitioner
Primary
169400
GA
Other
Enumeration date
01/25/2019
Last updated
12/21/2023
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