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General NPI Number Information
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NPI Number | 1972176386
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Entity Type | Individual
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Provider Name | JASMIN K JOSEPH NP
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Gender | Female
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Dates
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Enumeration Date | 07/22/2021
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 4300 WESTBROOK RD BLDG A
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City | SUWANEE
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State | GA
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Zip | 30024-4987
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Country | US
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Telephone | 678-765-7550
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Fax |
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Provider Business Mailing Address
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Address Line | 2507 COLBY CT
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City | SNELLVILLE
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State | GA
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Zip | 30078-2366
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Country | US
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Telephone | 203-271-1456
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN268801
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License Number State | GA
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