Healthcare Provider Details

I. General information

NPI: 1790691020
Provider Name (Legal Business Name): JESSENIA EFFIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 N POINT PKWY STE 204
ALPHARETTA GA
30005-4708
US

IV. Provider business mailing address

3275 N POINT PKWY STE 204
ALPHARETTA GA
30005-4708
US

V. Phone/Fax

Practice location:
  • Phone: 470-704-9687
  • Fax:
Mailing address:
  • Phone: 470-704-9687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP304623
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: