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NPI Code Detail

MEDICARE: JESSI LUCAS HALE ARNP

MEDICARE:   JESSI LUCAS HALE  ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse PractitionerRN197929GA

General Provider Information

NPI Number : 1053662874
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSI LUCAS HALE ARNP
Provider Business Mailing Address
First Line : 6801 RIVER RD STE 301
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-3353
Country : US
Telephone Number : 706-494-0694
Fax Number : 706-494-0695
Provider Business Practice Location Address
First Line : 6801 RIVER RD STE 301
Second Line :
City : COLUMBUS
State : GA
Zip : 31904-3353
Country : US
Telephone Number : 706-494-0694
Fax Number : 706-494-0695
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2012
Last Update Date : 12/03/2015

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Directions to “ JESSI LUCAS HALE ARNP” Practice Location

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