Individual
MS. MARY JENNIFER CLOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
462 ELMA G MILES PKWY STE 102A, HINESVILLE, GA 31313-4000
(912) 369-9400
Mailing address
100 S MADISON ST, THOMASVILLE, GA 31792-5473
(229) 236-0831
(229) 236-0871
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN165558
GA
363LA2100X
Acute Care Nurse Practitioner
RN165558
GA
Other
Enumeration date
05/31/2008
Last updated
02/07/2019
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