Puckett, Jennifer H
Puckett, Jennifer H is an individual health care provider with primary practice located at 777 Franklin Rd Se , Marietta GA 30067-7803. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Puckett, Jennifer H can be contacted via phone (770) 732-6007.Contact Information
Primary practice address
777 Franklin Rd Se
Marietta GA 30067-7803
Phone: (770) 732-6007
Fax: (770) 732-8242
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 628818 | Texas |
Profile Details
| NPI number | 1710931548 |
|---|---|
| LBN Legal business name | Puckett, Jennifer H |
| Credentials | MSN, ARNP, CPNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2006 |
| Last updated | Feb 4th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710931548 | NPPES |
| Texas | MEDICAID | 152489401 |
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