Healthcare Provider Details

I. General information

NPI: 1952235160
Provider Name (Legal Business Name): JESSICA HELENE MANITESCU ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA HELENE QUINLAN

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 MOUNT VERNON HWY NE STE 530
SANDY SPRINGS GA
30328-4287
US

IV. Provider business mailing address

555 SPENDER TRCE
SANDY SPRINGS GA
30350-5017
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-7970
  • Fax:
Mailing address:
  • Phone: 843-696-3635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN-NP249493
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: