Jackson, Stephanie Brazeal
Jackson, Stephanie Brazeal is an sole proprietor health care provider with primary practice located at 711 Trestle Rd , Locust Grove GA 30248-3465. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Jackson, Stephanie Brazeal can be contacted via phone (770) 914-5934.Contact Information
Primary practice address
711 Trestle Rd
Locust Grove GA 30248-3465
Phone: (770) 914-5934
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | RN071218 | Georgia |
Profile Details
| NPI number | 1255512984 |
|---|---|
| LBN Legal business name | Jackson, Stephanie Brazeal |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2007 |
| Last updated | Jul 29th, 2015 - about 9 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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