Individual
JESSICA PAIGE LONGSHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5860
Mailing address
133 LAUREL DR, MIDWAY, GA 31320-3762
(912) 572-7430
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN206692
GA
Other
Enumeration date
09/16/2014
Last updated
09/16/2014
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