Individual
JACQUITA GRESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
95 STONE RIDGE WAY, COVINGTON, GA 30016-6923
(470) 621-5877
Mailing address
95 STONE RIDGE WAY, COVINGTON, GA 30016-6923
(470) 621-5877
Taxonomy
Speciality
Code
Description
License number
State
364SH0200X
Home Health Clinical Nurse Specialist
Primary
873976524
GA
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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