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General NPI Number Information
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NPI Number | 1699335810
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Entity Type | Individual
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Provider Name | JENNIFER MONSRUD NP
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Gender | Female
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 794 MCDONOUGH RD
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City | JACKSON
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State | GA
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Zip | 30233-1572
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Country | US
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Telephone | 470-251-5300
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Fax | 470-251-5301
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Provider Business Mailing Address
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Address Line | 794 MCDONOUGH RD
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City | JACKSON
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State | GA
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Zip | 30233-1572
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Country | US
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Telephone | 470-251-5300
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Fax | 470-251-5301
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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 | 163WX0800X
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Taxonomy Name | Orthopedic Registered Nurse
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License Number | RN220568
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN220568
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP220568
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License Number State | GA
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