MEDICARE: JESSICA DAY NP

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
1	363LF0000X	Family Nurse Practitioner	RN268849	GA

General Provider Information

NPI Number	:	1306502448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA DAY NP

Provider Business Mailing Address
First Line	:	460 NORTHSIDE CHEROKEE BLVD STE 410
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-8023
Country	:	US
Telephone Number	:	678-786-7430
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 NORTHSIDE CHEROKEE BLVD STE 410
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-8023
Country	:	US
Telephone Number	:	678-786-7430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	11/12/2021

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Directions to “ JESSICA DAY NP” Practice Location

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