Healthcare Provider Details

I. General information

NPI: 1881408953
Provider Name (Legal Business Name): JESSICA NICOLE SINCLAIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESS SINCLAIR

II. Dates (important events)

Enumeration Date: 02/06/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 6552
AMERICUS GA
31709-6552
US

IV. Provider business mailing address

PO BOX 6552
AMERICUS GA
31709-6552
US

V. Phone/Fax

Practice location:
  • Phone: 404-202-7364
  • Fax:
Mailing address:
  • Phone: 404-202-7364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: