Gresham, Jacquita

Gresham, Jacquita is an individual health care provider with primary practice located at 95 Stone Ridge Way , Covington GA 30016-6923. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Home Health, which is considered as her primary health care specialty. Gresham, Jacquita can be contacted via phone (470) 621-5877.

Contact Information

Primary practice address
95 Stone Ridge Way Covington GA 30016-6923
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Home Health 364SH0200X 873976524 Georgia

Profile Details

NPI number 1902538887
LBN Legal business name Gresham, Jacquita
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2022
Last updated Jun 28th, 2022 - 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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