Martin, Jacquelyn Hairston

Martin, Jacquelyn Hairston is an individual health care provider with primary practice located at 107 Upper Riverdale Rd Sw Suite B, Riverdale GA 30274-2540. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Martin, Jacquelyn Hairston can be contacted via phone (770) 692-2800.

Contact Information

Primary practice address
107 Upper Riverdale Rd Sw Suite B Riverdale GA 30274-2540
Phone: (770) 692-2800
Fax: (770) 692-2804
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN052052 Georgia

Profile Details

NPI number 1659434876
LBN Legal business name Martin, Jacquelyn Hairston
Credentials C-FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Jul 8th, 2007 - about 17 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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