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NPI Code Detail

MEDICARE: JARRETT HAYLES-PATTERSON FNP-C

MEDICARE: JARRETT HAYLES-PATTERSON FNP-C
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
1363LF0000XFamily Nurse PractitionerRN211362GA

General Provider Information

NPI Number : 1902542152
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARRETT HAYLES-PATTERSON FNP-C
Provider Business Mailing Address
First Line : 174 WHETSTONE WAY
Second Line :
City : VILLA RICA
State : GA
Zip : 30180-6940
Country : US
Telephone Number : 973-508-9572
Fax Number :
Provider Business Practice Location Address
First Line : 7869 VILLA RICA HWY
Second Line :
City : DALLAS
State : GA
Zip : 30157-8638
Country : US
Telephone Number : 770-459-8449
Fax Number : 404-446-3342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2022
Last Update Date : 02/27/2024

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Directions to “ JARRETT HAYLES-PATTERSON FNP-C” Practice Location

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