Jefferson, Anjelica

Jefferson, Anjelica is an individual health care provider with primary practice located at 743 Spring St Ne , Gainesville GA 30501-3715. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Jefferson, Anjelica can be contacted via phone (770) 535-3611.

Contact Information

Primary practice address
743 Spring St Ne Gainesville GA 30501-3715
Phone: (770) 535-3611
Fax: (770) 535-7092
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN230248 Zz
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN230248 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Critical Care 363LP0222X RN230248 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN230248 Georgia

Profile Details

NPI number 1568126118
LBN Legal business name Jefferson, Anjelica
Credentials CPNP-AC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2021
Last updated Nov 6th, 2023 - about last year

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 1568126118 NPPES
Georgia Other 003262836 MEDICAID

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