Amazon, Jody L

Amazon, Jody L is an sole proprietor health care provider with primary practice located at 2160 Fountain Dr Ste 220 , Snellville GA 30078-7022. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Amazon, Jody L can be contacted via phone (678) 336-9102.

Contact Information

Primary practice address
2160 Fountain Dr Ste 220 Snellville GA 30078-7022
Phone: (678) 336-9102
Fax: (770) 674-8563
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R096082 Georgia

Profile Details

NPI number 1427038470
LBN Legal business name Amazon, Jody L
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 18th, 2006
Last updated Jan 14th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427038470 NPPES
Georgia MEDICAID 000771196C
Georgia Other 50BBKVV

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