Healthcare Provider Details

I. General information

NPI: 1043033376
Provider Name (Legal Business Name): JESSICA POE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2024
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 CYPRESS MILL RD STE 101
BRUNSWICK GA
31520-2879
US

IV. Provider business mailing address

3441 CYPRESS MILL RD STE 101
BRUNSWICK GA
31520-2879
US

V. Phone/Fax

Practice location:
  • Phone: 912-275-4763
  • Fax: 912-216-3668
Mailing address:
  • Phone: 912-275-4763
  • Fax: 912-216-3668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JESSICA COLEMAN
Title or Position: CEO, NP
Credential: FNP-C, PMHNP-BC
Phone: 912-275-4763