Individual
JESSICA LYNN GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
950 15TH ST, AUGUSTA, GA 30901-2608
(706) 733-0188
Mailing address
308 CASTLE VALE RD, IRMO, SC 29063-2620
(803) 443-1910
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
238478
SC
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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