De La Cruz, Jennifer Sue

De La Cruz, Jennifer Sue is an individual health care provider with primary practice located at 2701 N. Decatur Road , Decatur GA 30033. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. De La Cruz, Jennifer Sue can be contacted via phone (404) 501-1849.

Contact Information

Primary practice address
2701 N. Decatur Road Decatur GA 30033
Phone: (404) 501-1849
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 003777 Georgia

Profile Details

NPI number 1912942046
LBN Legal business name De La Cruz, Jennifer Sue
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2006
Last updated Jun 9th, 2021 - about 3 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 1912942046 NPPES
Georgia MEDICAID 424463934B
Georgia MEDICAID 424463934C

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