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General NPI Number Information
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NPI Number | 1972167740
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Entity Type | Individual
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Provider Name | JESSICA C TERRELL APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 04/27/2019
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 615 PEACHTREE ST NE
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City | ATLANTA
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State | GA
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Zip | 30308-2309
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Country | US
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Telephone | 833-377-6866
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Fax |
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Provider Business Mailing Address
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Address Line | 636 BLACKWATER RDG
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City | CANTON
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State | GA
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Zip | 30114-1225
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Country | US
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Telephone | 904-654-5868
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN-NP339542
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License Number State | GA
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