Individual
MS. GWENETH FERDINAND-JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
763 MCCLAIN DR, CLARKSVILLE, TN 37040
(931) 906-1823
(731) 352-7644
Mailing address
763 MCCLAIN DR, CLARKSVILLE, TN 37040-5695
(931) 906-1823
(731) 352-7644
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA969
TN
Other
Enumeration date
02/24/2006
Last updated
04/17/2012
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