MEDICARE: JESSICA HOWINGTON APRN- FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN177867	GA

General Provider Information

NPI Number	:	1659639482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA HOWINGTON APRN- FNP

Provider Business Mailing Address
First Line	:	250 10TH ST NE
Second Line	:	#2115
City	:	ATLANTA
State	:	GA
Zip	:	30309-3735
Country	:	US
Telephone Number	:	706-202-7555
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 10TH ST NE
Second Line	:	#2115
City	:	ATLANTA
State	:	GA
Zip	:	30309-3735
Country	:	US
Telephone Number	:	706-202-7555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2012
Last Update Date	:	04/30/2012

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