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General NPI Number Information
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NPI Number | 1437464427
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Entity Type | Individual
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Provider Name | JODIE ANN BLONS PNP
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Gender | Female
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 04/27/2021
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Provider Practice Location Address
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Address Line | 35 JESSE HILL JR DR SE
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City | ATLANTA
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State | GA
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Zip | 30303-3032
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Country | US
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Telephone | 404-785-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 1180 ERNEST W BARRETT PKWY NW STE 102B
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City | KENNESAW
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State | GA
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Zip | 30144-4534
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Country | US
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Telephone | 678-354-2273
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | RN118621
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License Number State | GA
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