Individual
JESSICA HAYNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
245 COUNTRY CLUB DR, STOCKBRIDGE, GA 30281-9080
(770) 389-4543
Mailing address
237 WALDEN POND TRL, SENOIA, GA 30276-6729
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN231788
GA
Other
Enumeration date
07/30/2018
Last updated
08/15/2023
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