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NPI Code Detail

MEDICARE: JESSLYN C SHIELDS

MEDICARE: JESSLYN C SHIELDS
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
1261QR0400XRehabilitation Clinic/CenterGA

General Provider Information

NPI Number : 1922975044
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSLYN C SHIELDS
Provider Business Mailing Address
First Line : 315 RIVERMONT RD
Second Line :
City : ATHENS
State : GA
Zip : 30606-2343
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 675 PULASKI ST STE 1400
Second Line :
City : ATHENS
State : GA
Zip : 30601-2384
Country : US
Telephone Number : 762-499-2894
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2025
Last Update Date : 10/22/2025

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Directions to “ JESSLYN C SHIELDS ” Practice Location

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