Individual
AGNES REENE JAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 PIKE DR, ELLERSLIE, GA 31807-5548
(706) 593-5539
Mailing address
500 PIKE DR, ELLERSLIE, GA 31807-5548
(706) 593-5539
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN306752
GA
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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